Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.67 / $10.84 / $25.35	Facility	26	$7.67	$10.84	$25.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.09 / $70.00 / $189.59	Professional		$32.09	$70.00	$189.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.68 / $10.66 / $25.35	Professional	26	$7.68	$10.66	$25.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.25 / $40.65 / $96.77	Professional	TC	$24.25	$40.65	$96.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.63 / $30.48 / $37.35	Professional		$25.63	$30.48	$37.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.53 / $8.91 / $15.79	Professional	26	$6.53	$8.91	$15.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.99 / $26.99 / $26.99	Professional	TC	$26.99	$26.99	$26.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.78 / $35.81 / $148.31	Professional		$27.78	$35.81	$148.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.58 / $8.61 / $22.08	Professional	26	$6.58	$8.61	$22.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.80 / $27.20 / $106.24	Professional	TC	$20.80	$27.20	$106.24
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $13.72 / $39.53 / $53.24	Professional		$13.72	$39.53	$53.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.95 / $86.14 / $208.79	Professional		$31.95	$86.14	$208.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.14 / $13.19 / $28.75	Professional	26	$7.14	$13.19	$28.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.75 / $68.08 / $165.97	Professional	TC	$23.75	$68.08	$165.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $40.85 / $62.80 / $124.17	Professional		$40.85	$62.80	$124.17
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.85 / $12.34 / $21.28	Professional	26	$8.85	$12.34	$21.28
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.64 / $39.96 / $73.13	Professional	TC	$30.64	$39.96	$73.13
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.40 / $59.57 / $100.45	Professional		$36.40	$59.57	$100.45
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.91 / $12.40 / $20.09	Professional	26	$5.91	$12.40	$20.09
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.56 / $45.08 / $61.84	Professional	TC	$27.56	$45.08	$61.84
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $39.75 / $41.96 / $73.38	Professional		$39.75	$41.96	$73.38
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $11.08 / $11.08 / $11.25	Professional	26	$11.08	$11.08	$11.25
Fidelis Facility/Professional Professional Modifier TC Low / Median / High Price $65.42 / $65.42 / $65.42	Professional	TC	$65.42	$65.42	$65.42
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.63 / $44.54 / $65.59	Professional		$37.63	$44.54	$65.59
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.91 / $11.96 / $22.48	Professional	26	$9.91	$11.96	$22.48
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $74.55 / $206.83	Professional		$36.31	$74.55	$206.83
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $12.86 / $27.85	Professional	26	$7.51	$12.86	$27.85
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $24.33 / $44.16 / $129.90	Professional	TC	$24.33	$44.16	$129.90
United Facility/Professional Professional Modifier Low / Median / High Price $30.75 / $48.30 / $112.90	Professional		$30.75	$48.30	$112.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.91 / $10.11 / $22.33	Professional	26	$6.91	$10.11	$22.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.19 / $35.93 / $94.33	Professional	TC	$23.19	$35.93	$94.33
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $10.11 / $10.11 / $30.81	Facility	26	$10.11	$10.11	$30.81
Univera Facility/Professional Professional Modifier Low / Median / High Price $39.01 / $57.84 / $100.45	Professional		$39.01	$57.84	$100.45
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $5.91 / $14.07 / $25.24	Professional	26	$5.91	$14.07	$25.24
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $29.44 / $43.77 / $75.20	Professional	TC	$29.44	$43.77	$75.20