Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $15.85 / $81.28	Facility	26	$10.96	$15.85	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $46.77 / $165.96	Professional		$28.84	$46.77	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $15.14 / $58.88	Professional	26	$10.00	$15.14	$58.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $21.88 / $44.67	Professional	TC	$17.78	$21.88	$44.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $28.84 / $33.11	Professional		$26.92	$28.84	$33.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $16.98 / $16.98	Professional	26	$16.98	$16.98	$16.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $36.31 / $72.44	Professional		$30.20	$36.31	$72.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.88 / $25.70	Professional	26	$10.47	$12.88	$25.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $23.44 / $45.71	Professional	TC	$19.50	$23.44	$45.71
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $29.51 / $44.67	Professional		$15.49	$29.51	$44.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.51 / $11.75 / $16.98	Facility	26	$2.51	$11.75	$16.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $51.29 / $123.03	Professional		$28.84	$51.29	$123.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $19.95 / $45.71	Professional	26	$10.23	$19.95	$45.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $33.88 / $81.28	Professional	TC	$18.62	$33.88	$81.28
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $52.48 / $69.18	Professional		$35.48	$52.48	$69.18
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $16.60 / $21.88	Professional	26	$11.22	$16.60	$21.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $35.48 / $46.77	Professional	TC	$25.12	$35.48	$46.77
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $38.02 / $64.57	Professional		$21.38	$38.02	$64.57
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $13.18 / $22.39	Professional	26	$9.55	$13.18	$22.39
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $24.55 / $42.66	Professional	TC	$13.80	$24.55	$42.66
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $10.96 / $10.96	Professional	26	$10.96	$10.96	$10.96
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $51.29 / $83.18	Professional		$42.66	$51.29	$83.18
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $19.05 / $28.84	Professional	26	$15.85	$19.05	$28.84
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $30.90 / $53.70	Professional	TC	$26.30	$30.90	$53.70
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $39.81 / $89.13	Professional		$30.20	$39.81	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $15.14 / $33.11	Professional	26	$10.47	$15.14	$33.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.70 / $57.54	Professional	TC	$19.05	$25.70	$57.54
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $7.24 / $12.30 / $19.05	Facility	26	$7.24	$12.30	$19.05
Univera Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $36.31 / $72.44	Professional		$23.99	$36.31	$72.44
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $13.18 / $26.92	Professional	26	$8.51	$13.18	$26.92
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $23.44 / $47.86	Professional	TC	$14.79	$23.44	$47.86