Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.71 / $37.97 / $77.56	Facility	26	$22.71	$37.97	$77.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.94 / $114.02 / $215.01	Professional		$84.94	$114.02	$215.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.71 / $29.30 / $68.03	Professional	26	$22.71	$29.30	$68.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.22 / $78.81 / $145.38	Professional	TC	$62.22	$78.81	$145.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.97 / $94.97 / $190.30	Professional		$94.97	$94.97	$190.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.81 / $25.52 / $51.24	Professional	26	$15.81	$25.52	$51.24
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $139.06 / $139.06 / $139.06	Professional	TC	$139.06	$139.06	$139.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.62 / $123.71 / $269.58	Professional		$99.62	$123.71	$269.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.61 / $33.04 / $68.09	Professional	26	$26.61	$33.04	$68.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.01 / $90.67 / $191.46	Professional	TC	$73.01	$90.67	$191.46
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $41.03 / $109.71 / $150.74	Professional		$41.03	$109.71	$150.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $32.36 / $32.36	Facility	26	$32.36	$32.36	$32.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.63 / $151.55 / $329.68	Professional		$82.63	$151.55	$329.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.04 / $40.60 / $86.40	Professional	26	$22.04	$40.60	$86.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.06 / $114.70 / $244.69	Professional	TC	$60.06	$114.70	$244.69
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $109.46 / $142.00 / $215.45	Professional		$109.46	$142.00	$215.45
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.00 / $37.39 / $59.09	Professional	26	$28.00	$37.39	$59.09
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $81.45 / $103.07 / $156.58	Professional	TC	$81.45	$103.07	$156.58
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.65 / $139.25 / $229.49	Professional		$84.65	$139.25	$229.49
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.80 / $38.20 / $62.93	Professional	26	$23.80	$38.20	$62.93
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.43 / $101.05 / $166.56	Professional	TC	$61.43	$101.05	$166.56
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $59.21 / $60.24 / $106.58	Professional		$59.21	$60.24	$106.58
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.13 / $107.72 / $112.62	Professional		$107.13	$107.72	$112.62
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.39 / $33.61 / $59.47	Professional	26	$30.39	$33.61	$59.47
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $32.36 / $32.36	Facility	26	$32.36	$32.36	$32.36
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $94.75 / $148.47 / $323.08	Professional		$94.75	$148.47	$323.08
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $23.40 / $40.33 / $84.98	Professional	26	$23.40	$40.33	$84.98
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $65.97 / $107.84 / $239.99	Professional	TC	$65.97	$107.84	$239.99
United Facility/Professional Professional Modifier Low / Median / High Price $85.75 / $109.71 / $237.68	Professional		$85.75	$109.71	$237.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.07 / $30.32 / $71.98	Professional	26	$22.07	$30.32	$71.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.23 / $81.20 / $198.26	Professional	TC	$63.23	$81.20	$198.26
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $33.06 / $33.06 / $45.31	Facility	26	$33.06	$33.06	$45.31
Univera Facility/Professional Professional Modifier Low / Median / High Price $97.93 / $155.56 / $272.30	Professional		$97.93	$155.56	$272.30
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $26.86 / $42.66 / $74.70	Professional	26	$26.86	$42.66	$74.70
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $71.08 / $112.90 / $197.60	Professional	TC	$71.08	$112.90	$197.60