Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.17 / $33.11 / $71.42	Facility	26	$24.17	$33.11	$71.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.22 / $129.37 / $490.00	Professional		$52.22	$129.37	$490.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.99 / $41.92 / $115.89	Professional	26	$24.99	$41.92	$115.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.04 / $84.53 / $138.75	Professional	TC	$28.04	$84.53	$138.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.83 / $127.90 / $199.04	Professional		$74.83	$127.90	$199.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.15 / $24.22 / $45.57	Professional	26	$22.15	$24.22	$45.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.97 / $108.00 / $242.62	Professional		$86.97	$108.00	$242.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.03 / $31.73 / $70.03	Professional	26	$25.03	$31.73	$70.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.56 / $74.61 / $151.81	Professional	TC	$60.56	$74.61	$151.81
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $44.48 / $103.51 / $147.99	Professional		$44.48	$103.51	$147.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.36 / $34.36 / $34.36	Facility	26	$34.36	$34.36	$34.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.84 / $136.18 / $359.53	Professional		$74.84	$136.18	$359.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.52 / $43.10 / $92.29	Professional	26	$23.52	$43.10	$92.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.98 / $95.64 / $256.68	Professional	TC	$45.98	$95.64	$256.68
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $92.37 / $135.13 / $203.48	Professional		$92.37	$135.13	$203.48
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.47 / $39.07 / $62.63	Professional	26	$28.47	$39.07	$62.63
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $73.42 / $92.83 / $141.13	Professional	TC	$73.42	$92.83	$141.13
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.23 / $117.58 / $210.73	Professional		$81.23	$117.58	$210.73
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.57 / $39.86 / $63.91	Professional	26	$17.57	$39.86	$63.91
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $56.60 / $85.46 / $146.82	Professional	TC	$56.60	$85.46	$146.82
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $70.94 / $101.99 / $110.84	Professional		$70.94	$101.99	$110.84
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $22.73 / $27.06 / $27.06	Professional	26	$22.73	$27.06	$27.06
Fidelis Facility/Professional Professional Modifier TC Low / Median / High Price $65.31 / $65.31 / $65.31	Professional	TC	$65.31	$65.31	$65.31
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.38 / $129.49 / $220.97	Professional		$108.38	$129.49	$220.97
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.86 / $39.15 / $73.53	Professional	26	$35.86	$39.15	$73.53
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $34.36 / $34.36 / $34.36	Facility	26	$34.36	$34.36	$34.36
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $88.42 / $140.29 / $331.79	Professional		$88.42	$140.29	$331.79
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $24.92 / $42.72 / $91.62	Professional	26	$24.92	$42.72	$91.62
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $54.40 / $95.22 / $230.94	Professional	TC	$54.40	$95.22	$230.94
United Facility/Professional Professional Modifier Low / Median / High Price $80.59 / $106.83 / $250.88	Professional		$80.59	$106.83	$250.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.84 / $31.73 / $70.89	Professional	26	$22.84	$31.73	$70.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.37 / $74.34 / $165.09	Professional	TC	$56.37	$74.34	$165.09
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $35.07 / $35.07 / $103.02	Facility	26	$35.07	$35.07	$103.02
Univera Facility/Professional Professional Modifier Low / Median / High Price $84.20 / $133.63 / $261.30	Professional		$84.20	$133.63	$261.30
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $17.57 / $40.53 / $81.84	Professional	26	$17.57	$40.53	$81.84
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $66.62 / $93.10 / $186.56	Professional	TC	$66.62	$93.10	$186.56