Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.58 / $25.22 / $62.25	Facility	26	$15.58	$25.22	$62.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.42 / $235.36 / $654.29	Professional		$164.42	$235.36	$654.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.59 / $23.91 / $55.58	Professional	26	$15.59	$23.91	$55.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $148.83 / $204.00 / $561.29	Professional	TC	$148.83	$204.00	$561.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.59 / $29.59 / $29.59	Professional	26	$29.59	$29.59	$29.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $207.55 / $257.75 / $539.10	Professional		$207.55	$257.75	$539.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.72 / $25.01 / $50.03	Professional	26	$19.72	$25.01	$50.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $187.83 / $233.25 / $475.03	Professional	TC	$187.83	$233.25	$475.03
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $33.86 / $302.30 / $336.16	Professional		$33.86	$302.30	$336.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $26.30 / $26.30	Facility	26	$26.30	$26.30	$26.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $171.41 / $333.20 / $744.02	Professional		$171.41	$333.20	$744.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.32 / $31.05 / $67.93	Professional	26	$16.32	$31.05	$67.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.59 / $308.44 / $676.10	Professional	TC	$154.59	$308.44	$676.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $206.31 / $283.29 / $433.77	Professional		$206.31	$283.29	$433.77
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.32 / $28.58 / $48.11	Professional	26	$20.32	$28.58	$48.11
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $175.31 / $245.82 / $408.00	Professional	TC	$175.31	$245.82	$408.00
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.61 / $204.69 / $342.92	Professional		$83.61	$204.69	$342.92
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.45 / $23.29 / $40.22	Professional	26	$19.45	$23.29	$40.22
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.16 / $185.24 / $306.12	Professional	TC	$50.16	$185.24	$306.12
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $226.75 / $273.14 / $420.48	Professional		$226.75	$273.14	$420.48
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.97 / $45.15 / $56.49	Professional	26	$27.97	$45.15	$56.49
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $26.30 / $26.30	Facility	26	$26.30	$26.30	$26.30
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $171.41 / $344.33 / $744.02	Professional		$171.41	$344.33	$744.02
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $17.66 / $31.42 / $67.93	Professional	26	$17.66	$31.42	$67.93
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $170.83 / $313.27 / $676.10	Professional	TC	$170.83	$313.27	$676.10
United Facility/Professional Professional Modifier Low / Median / High Price $208.01 / $272.82 / $593.95	Professional		$208.01	$272.82	$593.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.52 / $26.94 / $57.25	Professional	26	$20.52	$26.94	$57.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $188.46 / $254.42 / $538.13	Professional	TC	$188.46	$254.42	$538.13
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $24.63 / $24.63 / $41.26	Facility	26	$24.63	$24.63	$41.26
Univera Facility/Professional Professional Modifier Low / Median / High Price $197.17 / $289.02 / $508.48	Professional		$197.17	$289.02	$508.48
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $19.45 / $31.02 / $54.58	Professional	26	$19.45	$31.02	$54.58
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $175.31 / $257.99 / $453.90	Professional	TC	$175.31	$257.99	$453.90