Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $45.71 / $79.43	Facility		$44.67	$45.71	$79.43
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $10.47 / $10.47	Facility	26	$10.47	$10.47	$10.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $37.15 / $87.10	Professional		$20.89	$37.15	$87.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $14.45 / $43.65	Professional	26	$5.01	$14.45	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $26.92 / $58.88	Professional	TC	$15.85	$26.92	$58.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $36.31 / $120.23	Professional		$22.39	$36.31	$120.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $3.02 / $8.32 / $30.20	Professional	26	$3.02	$8.32	$30.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $25.70 / $93.33	Professional	TC	$19.95	$25.70	$93.33
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $4.07 / $9.77 / $33.88	Facility		$4.07	$9.77	$33.88
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $22.39 / $43.65	Professional		$9.77	$22.39	$43.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $66.07 / $74.13	Facility		$54.95	$66.07	$74.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.62 / $7.59 / $10.72	Facility	26	$1.62	$7.59	$10.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $39.81 / $131.83	Professional		$19.05	$39.81	$131.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.63 / $8.51 / $22.91	Professional	26	$3.63	$8.51	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $31.62 / $114.82	Professional	TC	$14.79	$31.62	$114.82
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $5.01 / $5.01 / $5.01	Facility		$5.01	$5.01	$5.01
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $31.62 / $58.88	Professional		$24.55	$31.62	$58.88
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $7.76 / $48.98	Professional	26	$5.01	$7.76	$48.98
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.18 / $46.77	Professional	TC	$19.95	$28.18	$46.77
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $46.77 / $64.57	Professional		$24.55	$46.77	$64.57
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.50 / $9.55 / $17.78	Professional	26	$5.50	$9.55	$17.78
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $37.15 / $45.71	Professional	TC	$19.05	$37.15	$45.71
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $7.08 / $13.18	Professional	26	$6.92	$7.08	$13.18
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $36.31	Professional		$32.36	$33.11	$36.31
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $6.61 / $7.94	Professional	26	$6.61	$6.61	$7.94
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $26.92 / $31.62	Professional	TC	$24.55	$26.92	$31.62
United Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $22.91 / $57.54	Professional		$16.98	$22.91	$57.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.47 / $4.68 / $12.59	Professional	26	$3.47	$4.68	$12.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $17.78 / $46.77	Professional	TC	$13.18	$17.78	$46.77
Univera Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $41.69 / $69.18	Professional		$24.55	$41.69	$69.18
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $5.50 / $8.51 / $19.95	Professional	26	$5.50	$8.51	$19.95
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.84 / $54.95	Professional	TC	$19.05	$28.84	$54.95