Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $14.45 / $89.13	Facility		$13.49	$14.45	$89.13
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.78 / $17.78 / $17.78	Facility	26	$17.78	$17.78	$17.78
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $8.71 / $12.59 / $23.44	Facility	TC	$8.71	$12.59	$23.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $19.05 / $51.29	Professional		$12.88	$19.05	$51.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $25.70 / $79.43	Professional	26	$8.91	$25.70	$79.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.01 / $7.08 / $19.95	Professional	TC	$5.01	$7.08	$19.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $18.62 / $18.62	Professional		$18.62	$18.62	$18.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $22.91 / $52.48	Professional		$9.12	$22.91	$52.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.37 / $14.13 / $30.20	Professional	26	$5.37	$14.13	$30.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.72 / $6.46 / $21.38	Professional	TC	$3.72	$6.46	$21.38
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $5.01 / $11.75 / $17.78	Facility		$5.01	$11.75	$17.78
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $15.14 / $29.51	Professional		$8.91	$15.14	$29.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $23.44 / $34.67	Facility		$19.50	$23.44	$34.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.16 / $14.79 / $21.38	Facility	26	$3.16	$14.79	$21.38
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $2.00 / $9.33 / $13.18	Facility	TC	$2.00	$9.33	$13.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $24.55 / $67.61	Professional		$10.96	$24.55	$67.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $15.49 / $40.74	Professional	26	$6.61	$15.49	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $4.17 / $10.00 / $28.84	Professional	TC	$4.17	$10.00	$28.84
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $2.00 / $2.00 / $2.00	Facility		$2.00	$2.00	$2.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $19.50 / $34.67	Professional		$14.79	$19.50	$34.67
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $12.02 / $18.20	Professional	26	$8.51	$12.02	$18.20
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $6.46 / $9.12 / $14.79	Professional	TC	$6.46	$9.12	$14.79
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $24.55 / $39.81	Professional		$16.60	$24.55	$39.81
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $14.45 / $23.44	Professional	26	$10.00	$14.45	$23.44
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $6.92 / $9.77 / $16.60	Professional	TC	$6.92	$9.77	$16.60
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $13.18 / $13.18	Professional	26	$13.18	$13.18	$13.18
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $12.88 / $24.55	Professional	26	$12.59	$12.88	$24.55
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $23.44	Professional		$20.42	$20.42	$23.44
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $11.75 / $14.13	Professional	26	$11.75	$11.75	$14.13
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $8.71 / $8.71 / $10.47	Professional	TC	$8.71	$8.71	$10.47
United Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $14.13 / $39.81	Professional		$10.23	$14.13	$39.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.32 / $22.39	Professional	26	$6.03	$8.32	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $4.47 / $6.03 / $13.49	Professional	TC	$4.47	$6.03	$13.49
Univera Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $22.39 / $42.66	Professional		$16.60	$22.39	$42.66
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $12.88 / $25.12	Professional	26	$9.77	$12.88	$25.12
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $6.92 / $9.33 / $17.78	Professional	TC	$6.92	$9.33	$17.78