Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.73 / $17.92 / $47.87	Facility	26	$11.73	$17.92	$47.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.95 / $54.56 / $146.77	Professional		$43.95	$54.56	$146.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.73 / $14.41 / $31.32	Professional	26	$11.73	$14.41	$31.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.22 / $37.71 / $74.80	Professional	TC	$31.22	$37.71	$74.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.23 / $55.21 / $138.91	Professional		$42.23	$55.21	$138.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.27 / $14.74 / $33.24	Professional	26	$11.27	$14.74	$33.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.95 / $40.06 / $97.50	Professional	TC	$30.95	$40.06	$97.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $21.10 / $52.42 / $73.52	Professional		$21.10	$52.42	$73.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.20 / $16.20 / $16.20	Facility	26	$16.20	$16.20	$16.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.36 / $75.58 / $167.96	Professional		$42.36	$75.58	$167.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.53 / $19.98 / $42.55	Professional	26	$10.53	$19.98	$42.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.87 / $56.17 / $123.30	Professional	TC	$30.87	$56.17	$123.30
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $54.65 / $72.51 / $110.02	Professional		$54.65	$72.51	$110.02
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.70 / $18.48 / $29.30	Professional	26	$13.70	$18.48	$29.30
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.89 / $53.22 / $86.08	Professional	TC	$40.89	$53.22	$86.08
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.55 / $71.08 / $117.20	Professional		$43.55	$71.08	$117.20
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.17 / $19.16 / $31.21	Professional	26	$12.17	$19.16	$31.21
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.56 / $51.92 / $85.99	Professional	TC	$31.56	$51.92	$85.99
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $58.54 / $67.78 / $68.48	Professional		$58.54	$67.78	$68.48
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.64 / $66.98 / $124.04	Professional		$59.64	$66.98	$124.04
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.32 / $18.29 / $29.86	Professional	26	$13.32	$18.29	$29.86
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $16.20 / $16.20 / $16.20	Facility	26	$16.20	$16.20	$16.20
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $43.86 / $79.16 / $159.88	Professional		$43.86	$79.16	$159.88
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $11.13 / $19.41 / $42.19	Professional	26	$11.13	$19.41	$42.19
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $31.43 / $54.48 / $117.70	Professional	TC	$31.43	$54.48	$117.70
United Facility/Professional Professional Modifier Low / Median / High Price $39.75 / $55.82 / $121.38	Professional		$39.75	$55.82	$121.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.08 / $15.41 / $36.90	Professional	26	$11.08	$15.41	$36.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.60 / $41.21 / $99.25	Professional	TC	$29.60	$41.21	$99.25
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $15.21 / $15.21 / $24.36	Facility	26	$15.21	$15.21	$24.36
Univera Facility/Professional Professional Modifier Low / Median / High Price $53.38 / $79.45 / $136.84	Professional		$53.38	$79.45	$136.84
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $14.39 / $21.15 / $38.83	Professional	26	$14.39	$21.15	$38.83
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $38.99 / $58.29 / $98.67	Professional	TC	$38.99	$58.29	$98.67