Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $20.89 / $47.86	Facility	26	$11.75	$20.89	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $60.26 / $165.96	Professional		$41.69	$60.26	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $15.49 / $46.77	Professional	26	$10.96	$15.49	$46.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $38.90 / $93.33	Professional	TC	$28.84	$38.90	$93.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $52.48 / $120.23	Professional		$42.66	$52.48	$120.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $14.13 / $29.51	Professional	26	$11.22	$14.13	$29.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $38.02 / $85.11	Professional	TC	$30.90	$38.02	$85.11
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $52.48 / $74.13	Professional		$20.89	$52.48	$74.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.47 / $16.22 / $22.91	Facility	26	$3.47	$16.22	$22.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $75.86 / $186.21	Professional		$43.65	$75.86	$186.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $20.89 / $50.12	Professional	26	$11.22	$20.89	$50.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $58.88 / $141.25	Professional	TC	$31.62	$58.88	$141.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $75.86 / $112.20	Professional		$57.54	$75.86	$112.20
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $21.38 / $42.66	Professional	26	$14.79	$21.38	$42.66
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $57.54 / $83.18	Professional	TC	$43.65	$57.54	$83.18
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $79.43 / $131.83	Professional		$48.98	$79.43	$131.83
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $21.38 / $35.48	Professional	26	$13.18	$21.38	$35.48
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $58.88 / $97.72	Professional	TC	$35.48	$58.88	$97.72
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $21.88 / $21.88	Professional	26	$21.88	$21.88	$21.88
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $61.66 / $89.13	Professional		$54.95	$61.66	$89.13
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $16.98 / $30.20	Professional	26	$13.18	$16.98	$30.20
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $72.44 / $138.04	Professional		$61.66	$72.44	$138.04
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $19.95 / $38.02	Professional	26	$16.60	$19.95	$38.02
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $52.48 / $102.33	Professional	TC	$44.67	$52.48	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $54.95 / $117.49	Professional		$39.81	$54.95	$117.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $14.79 / $32.36	Professional	26	$10.72	$14.79	$32.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $40.74 / $87.10	Professional	TC	$28.84	$40.74	$87.10
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $15.14 / $23.99	Facility	26	$11.48	$15.14	$23.99
Univera Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $70.79 / $134.90	Professional		$43.65	$70.79	$134.90
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $18.62 / $36.31	Professional	26	$11.75	$18.62	$36.31
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $51.29 / $97.72	Professional	TC	$31.62	$51.29	$97.72