Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.41 / $33.43 / $87.46	Facility	26	$20.41	$33.43	$87.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.69 / $102.71 / $231.54	Professional		$67.69	$102.71	$231.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.41 / $27.03 / $64.72	Professional	26	$20.41	$27.03	$64.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.28 / $73.75 / $151.50	Professional	TC	$47.28	$73.75	$151.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.54 / $14.54 / $14.54	Professional	26	$14.54	$14.54	$14.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.05 / $96.80 / $245.21	Professional		$74.05	$96.80	$245.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.97 / $24.81 / $58.40	Professional	26	$18.97	$24.81	$58.40
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.07 / $69.83 / $168.58	Professional	TC	$55.07	$69.83	$168.58
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $38.54 / $100.16 / $138.71	Professional		$38.54	$100.16	$138.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.07 / $30.07 / $30.07	Facility	26	$30.07	$30.07	$30.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.25 / $133.66 / $323.66	Professional		$78.25	$133.66	$323.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.51 / $36.54 / $79.77	Professional	26	$19.51	$36.54	$79.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.92 / $102.97 / $262.58	Professional	TC	$55.92	$102.97	$262.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $91.73 / $121.61 / $201.81	Professional		$91.73	$121.61	$201.81
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.64 / $33.99 / $54.21	Professional	26	$24.64	$33.99	$54.21
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $74.53 / $97.28 / $156.41	Professional	TC	$74.53	$97.28	$156.41
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.91 / $116.92 / $209.54	Professional		$77.91	$116.92	$209.54
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.62 / $34.50 / $55.91	Professional	26	$14.62	$34.50	$55.91
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $56.37 / $85.72 / $153.62	Professional	TC	$56.37	$85.72	$153.62
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.28 / $96.28 / $169.00	Professional		$96.28	$96.28	$169.00
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.34 / $55.87 / $64.30	Professional	26	$30.34	$55.87	$64.30
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $30.07 / $30.07 / $30.07	Facility	26	$30.07	$30.07	$30.07
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $83.82 / $130.90 / $309.89	Professional		$83.82	$130.90	$309.89
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $20.09 / $35.92 / $79.42	Professional	26	$20.09	$35.92	$79.42
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $57.96 / $91.09 / $231.51	Professional	TC	$57.96	$91.09	$231.51
United Facility/Professional Professional Modifier Low / Median / High Price $78.40 / $101.56 / $208.61	Professional		$78.40	$101.56	$208.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.95 / $27.82 / $60.41	Professional	26	$20.95	$27.82	$60.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.43 / $72.73 / $149.90	Professional	TC	$57.43	$72.73	$149.90
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $28.15 / $28.15 / $76.06	Facility	26	$28.15	$28.15	$76.06
Univera Facility/Professional Professional Modifier Low / Median / High Price $81.63 / $145.71 / $264.31	Professional		$81.63	$145.71	$264.31
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $14.62 / $39.14 / $70.92	Professional	26	$14.62	$39.14	$70.92
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $67.01 / $106.57 / $192.95	Professional	TC	$67.01	$106.57	$192.95