Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.51 / $41.60 / $80.13	Facility	26	$23.51	$41.60	$80.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.64 / $115.34 / $311.95	Professional		$57.64	$115.34	$311.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.51 / $31.50 / $103.76	Professional	26	$23.51	$31.50	$103.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.13 / $74.59 / $129.54	Professional	TC	$18.13	$74.59	$129.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.88 / $45.85 / $64.34	Professional		$35.88	$45.85	$64.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.65 / $40.65 / $40.65	Professional	26	$40.65	$40.65	$40.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.73 / $62.42 / $244.47	Professional		$48.73	$62.42	$244.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.79 / $30.17 / $74.52	Professional	26	$23.79	$30.17	$74.52
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $73.09 / $92.68 / $359.76	Professional	50	$73.09	$92.68	$359.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.46 / $30.03 / $169.38	Professional	TC	$23.46	$30.03	$169.38
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $43.71 / $50.03 / $93.74	Professional		$43.71	$50.03	$93.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.32 / $49.32 / $49.32	Facility	26	$49.32	$49.32	$49.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.41 / $140.63 / $261.20	Professional		$47.41	$140.63	$261.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.27 / $44.67 / $97.92	Professional	26	$23.27	$44.67	$97.92
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $115.21 / $115.21 / $115.21	Professional	50	$115.21	$115.21	$115.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.99 / $85.12 / $173.60	Professional	TC	$12.99	$85.12	$173.60
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $55.76 / $72.86 / $145.94	Professional		$55.76	$72.86	$145.94
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.61 / $55.54 / $89.10	Professional	26	$37.61	$55.54	$89.10
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.39 / $14.14 / $23.00	Professional	TC	$11.39	$14.14	$23.00
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.22 / $79.81 / $114.72	Professional		$44.22	$79.81	$114.72
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.32 / $56.69 / $91.89	Professional	26	$18.32	$56.69	$91.89
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.75 / $18.77 / $62.05	Professional	TC	$9.75	$18.77	$62.05
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $50.25 / $55.29 / $76.59	Professional		$50.25	$55.29	$76.59
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.25 / $76.41 / $130.69	Professional		$50.25	$76.41	$130.69
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.53 / $35.92 / $63.27	Professional	26	$35.53	$35.92	$63.27
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $49.32 / $49.32 / $49.32	Facility	26	$49.32	$49.32	$49.32
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $69.13 / $107.44 / $256.36	Professional		$69.13	$107.44	$256.36
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $27.36 / $43.20 / $87.10	Professional	26	$27.36	$43.20	$87.10
MVP Health Care Facility/Professional Professional Modifier 50 Low / Median / High Price $115.21 / $115.21 / $115.21	Professional	50	$115.21	$115.21	$115.21
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $17.21 / $62.98 / $147.66	Professional	TC	$17.21	$62.98	$147.66
United Facility/Professional Professional Modifier Low / Median / High Price $53.82 / $88.55 / $197.52	Professional		$53.82	$88.55	$197.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.90 / $32.63 / $77.65	Professional	26	$24.90	$32.63	$77.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.06 / $49.01 / $128.07	Professional	TC	$11.06	$49.01	$128.07
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $50.43 / $50.43 / $63.69	Facility	26	$50.43	$50.43	$63.69
Univera Facility/Professional Professional Modifier Low / Median / High Price $54.63 / $79.81 / $144.18	Professional		$54.63	$79.81	$144.18
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $18.32 / $56.69 / $110.74	Professional	26	$18.32	$56.69	$110.74
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $10.87 / $15.49 / $62.05	Professional	TC	$10.87	$15.49	$62.05