Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.28 / $66.28 / $66.28	Facility	26	$66.28	$66.28	$66.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $61.36 / $118.03	Professional		$45.00	$61.36	$118.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.45 / $35.53 / $53.63	Professional	26	$28.45	$35.53	$53.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.63 / $24.69 / $38.40	Professional	TC	$19.63	$24.69	$38.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.35 / $58.35 / $58.35	Professional		$58.35	$58.35	$58.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.15 / $34.15 / $34.15	Professional	26	$34.15	$34.15	$34.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.76 / $53.99 / $135.69	Professional		$42.76	$53.99	$135.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.32 / $31.98 / $76.54	Professional	26	$25.32	$31.98	$76.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.00 / $22.01 / $59.31	Professional	TC	$17.00	$22.01	$59.31
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $52.54 / $89.20	Professional		$36.65	$52.54	$89.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.59 / $41.59 / $41.59	Facility	26	$41.59	$41.59	$41.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.75 / $75.06 / $211.69	Professional		$41.75	$75.06	$211.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.03 / $44.75 / $121.50	Professional	26	$24.03	$44.75	$121.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.21 / $31.98 / $90.82	Professional	TC	$17.21	$31.98	$90.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $73.61 / $86.46 / $129.40	Professional		$73.61	$86.46	$129.40
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.96 / $50.07 / $74.93	Professional	26	$40.96	$50.07	$74.93
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.33 / $36.40 / $55.46	Professional	TC	$32.33	$36.40	$55.46
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $34.53 / $34.53 / $34.53	Facility	26	$34.53	$34.53	$34.53
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.21 / $59.63 / $111.27	Professional		$48.21	$59.63	$111.27
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.47 / $34.53 / $64.43	Professional	26	$27.47	$34.53	$64.43
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.74 / $25.10 / $46.84	Professional	TC	$20.74	$25.10	$46.84
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.63 / $75.48 / $76.55	Professional		$59.63	$75.48	$76.55
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $41.59 / $41.59 / $41.59	Facility	26	$41.59	$41.59	$41.59
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $44.95 / $77.72 / $203.26	Professional		$44.95	$77.72	$203.26
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $25.21 / $44.75 / $114.69	Professional	26	$25.21	$44.75	$114.69
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $18.80 / $31.20 / $90.10	Professional	TC	$18.80	$31.20	$90.10
United Facility/Professional Professional Modifier Low / Median / High Price $38.57 / $55.83 / $128.44	Professional		$38.57	$55.83	$128.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.21 / $34.07 / $73.83	Professional	26	$23.21	$34.07	$73.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.00 / $23.51 / $56.14	Professional	TC	$17.00	$23.51	$56.14
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $34.53 / $34.53 / $34.53	Facility	26	$34.53	$34.53	$34.53
Univera Facility/Professional Professional Modifier Low / Median / High Price $48.21 / $64.15 / $117.51	Professional		$48.21	$64.15	$117.51
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $27.47 / $37.14 / $68.04	Professional	26	$27.47	$37.14	$68.04
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $20.74 / $27.00 / $49.47	Professional	TC	$20.74	$27.00	$49.47