Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $41.69 / $97.72	Facility	26	$24.55	$41.69	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $120.23 / $295.12	Professional		$81.28	$120.23	$295.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $60.26 / $169.82	Professional	26	$22.91	$60.26	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $85.11 / $186.21	Professional	TC	$60.26	$85.11	$186.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Professional		$117.49	$117.49	$117.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $257.04	Professional		$53.70	$53.70	$257.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $14.79 / $64.57	Professional	26	$14.79	$14.79	$64.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $38.90 / $186.21	Professional	TC	$38.90	$38.90	$186.21
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $151.36 / $199.53	Professional		$48.98	$151.36	$199.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $70.79 / $102.33	Facility	26	$15.14	$70.79	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $147.91 / $524.81	Professional		$58.88	$147.91	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $38.02 / $109.65	Professional	26	$15.49	$38.02	$109.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $112.20 / $354.81	Professional	TC	$43.65	$112.20	$354.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $134.90 / $229.09	Professional		$95.50	$134.90	$229.09
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $33.88 / $61.66	Professional	26	$23.44	$33.88	$61.66
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $104.71 / $190.55	Professional	TC	$72.44	$104.71	$190.55
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $177.83 / $354.81	Professional		$107.15	$177.83	$354.81
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $40.74 / $72.44	Professional	26	$27.54	$40.74	$72.44
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $114.82 / $208.93	Professional	TC	$81.28	$114.82	$208.93
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $162.18 / $162.18	Professional	26	$162.18	$162.18	$162.18
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $66.07 / $70.79	Professional	26	$35.48	$66.07	$70.79
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $107.15 / $107.15	Professional	TC	$107.15	$107.15	$107.15
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $158.49	Professional		$131.83	$131.83	$158.49
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $32.36 / $38.90	Professional	26	$32.36	$32.36	$38.90
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $100.00 / $120.23	Professional	TC	$100.00	$100.00	$120.23
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $87.10 / $208.93	Professional		$63.10	$87.10	$208.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $21.88 / $53.70	Professional	26	$15.85	$21.88	$53.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $66.07 / $158.49	Professional	TC	$50.12	$66.07	$158.49
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $35.48 / $45.71	Facility	26	$14.79	$35.48	$45.71
Univera Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $158.49 / $354.81	Professional		$107.15	$158.49	$354.81
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $39.81 / $72.44	Professional	26	$27.54	$39.81	$72.44
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $107.15 / $208.93	Professional	TC	$81.28	$107.15	$208.93