Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.22 / $42.74 / $104.52	Facility	26	$32.22	$42.74	$104.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.88 / $111.47 / $691.23	Professional		$63.88	$111.47	$691.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.73 / $74.93 / $611.59	Professional	26	$28.73	$74.93	$611.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.66 / $45.02 / $101.80	Professional	TC	$31.66	$45.02	$101.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.59 / $53.59 / $73.69	Professional		$53.59	$53.59	$73.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.55 / $27.55 / $27.55	Professional	26	$27.55	$27.55	$27.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.05 / $73.27 / $167.52	Professional		$56.05	$73.27	$167.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.69 / $34.90 / $77.08	Professional	26	$26.69	$34.90	$77.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.35 / $38.11 / $94.89	Professional	TC	$29.35	$38.11	$94.89
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $46.07 / $47.17 / $93.24	Professional		$46.07	$47.17	$93.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.07 / $37.07 / $37.07	Facility	26	$37.07	$37.07	$37.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.93 / $101.70 / $214.94	Professional		$58.93	$101.70	$214.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.07 / $43.46 / $101.76	Professional	26	$28.07	$43.46	$101.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.86 / $54.53 / $113.18	Professional	TC	$30.86	$54.53	$113.18
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $65.78 / $90.99 / $138.05	Professional		$65.78	$90.99	$138.05
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.20 / $43.33 / $68.64	Professional	26	$31.20	$43.33	$68.64
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.52 / $47.85 / $83.64	Professional	TC	$34.52	$47.85	$83.64
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.31 / $62.75 / $123.15	Professional		$31.31	$62.75	$123.15
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.23 / $33.04 / $63.50	Professional	26	$21.23	$33.04	$63.50
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.79 / $37.15 / $61.92	Professional	TC	$18.79	$37.15	$61.92
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $68.23 / $68.23 / $68.23	Professional		$68.23	$68.23	$68.23
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $28.63 / $28.63 / $34.59	Professional	26	$28.63	$28.63	$34.59
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.02 / $73.38 / $74.45	Professional		$68.02	$73.38	$74.45
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.61 / $44.56 / $79.67	Professional	26	$33.61	$44.56	$79.67
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $37.07 / $37.07 / $37.07	Facility	26	$37.07	$37.07	$37.07
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $66.79 / $101.70 / $218.15	Professional		$66.79	$101.70	$218.15
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $31.82 / $44.08 / $100.09	Professional	26	$31.82	$44.08	$100.09
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $33.31 / $51.93 / $107.50	Professional	TC	$33.31	$51.93	$107.50
United Facility/Professional Professional Modifier Low / Median / High Price $57.67 / $76.62 / $160.52	Professional		$57.67	$76.62	$160.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.47 / $35.72 / $79.17	Professional	26	$26.47	$35.72	$79.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.14 / $40.77 / $83.66	Professional	TC	$29.14	$40.77	$83.66
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $34.94 / $34.94 / $97.91	Facility	26	$34.94	$34.94	$97.91
Univera Facility/Professional Professional Modifier Low / Median / High Price $58.38 / $86.01 / $190.16	Professional		$58.38	$86.01	$190.16
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $21.23 / $42.76 / $90.73	Professional	26	$21.23	$42.76	$90.73
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $31.55 / $43.25 / $95.61	Professional	TC	$31.55	$43.25	$95.61