Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.97 / $16.82 / $43.10	Facility	26	$10.97	$16.82	$43.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.16 / $45.65 / $120.75	Professional		$28.16	$45.65	$120.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.97 / $14.18 / $31.38	Professional	26	$10.97	$14.18	$31.38
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.08 / $19.80 / $34.78	Professional	52	$14.08	$19.80	$34.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.88 / $27.26 / $60.72	Professional	TC	$16.88	$27.26	$60.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.74 / $35.74 / $35.74	Professional		$35.74	$35.74	$35.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.59 / $19.59 / $19.59	Professional	26	$19.59	$19.59	$19.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.72 / $43.27 / $101.40	Professional		$33.72	$43.27	$101.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $12.31 / $31.37	Professional	26	$9.41	$12.31	$31.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.31 / $30.19 / $62.43	Professional	TC	$24.31	$30.19	$62.43
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $44.30 / $63.30	Professional		$19.00	$44.30	$63.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.96 / $14.96 / $14.96	Facility	26	$14.96	$14.96	$14.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.00 / $59.20 / $144.26	Professional		$34.00	$59.20	$144.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.15 / $18.57 / $40.15	Professional	26	$10.15	$18.57	$40.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.94 / $39.76 / $105.58	Professional	TC	$22.94	$39.76	$105.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $39.01 / $52.34 / $90.55	Professional		$39.01	$52.34	$90.55
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.26 / $17.21 / $26.97	Professional	26	$12.26	$17.21	$26.97
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.01 / $43.08 / $69.31	Professional	TC	$33.01	$43.08	$69.31
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.43 / $53.14 / $95.23	Professional		$26.43	$53.14	$95.23
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $17.16 / $27.82	Professional	26	$8.11	$17.16	$27.82
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.30 / $37.61 / $67.41	Professional	TC	$18.30	$37.61	$67.41
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $57.57 / $57.57 / $57.57	Professional		$57.57	$57.57	$57.57
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $15.60 / $15.60 / $15.60	Professional	26	$15.60	$15.60	$15.60
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.97 / $45.75 / $61.55	Professional		$41.97	$45.75	$61.55
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.59 / $16.18 / $27.44	Professional	26	$15.59	$16.18	$27.44
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $14.96 / $14.96 / $14.96	Facility	26	$14.96	$14.96	$14.96
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $36.10 / $59.23 / $139.56	Professional		$36.10	$59.23	$139.56
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $10.77 / $18.00 / $39.85	Professional	26	$10.77	$18.00	$39.85
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $23.10 / $38.70 / $99.70	Professional	TC	$23.10	$38.70	$99.70
United Facility/Professional Professional Modifier Low / Median / High Price $35.50 / $44.25 / $94.05	Professional		$35.50	$44.25	$94.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.62 / $14.97 / $33.44	Professional	26	$10.62	$14.97	$33.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.46 / $31.02 / $71.30	Professional	TC	$25.46	$31.02	$71.30
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $14.00 / $14.00 / $38.01	Facility	26	$14.00	$14.00	$38.01
Univera Facility/Professional Professional Modifier Low / Median / High Price $26.43 / $66.66 / $118.94	Professional		$26.43	$66.66	$118.94
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $19.48 / $34.96	Professional	26	$8.11	$19.48	$34.96
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $18.30 / $47.19 / $83.98	Professional	TC	$18.30	$47.19	$83.98