Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $41.69 / $72.44	Facility	26	$31.62	$41.69	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $75.86 / $165.96	Professional		$51.29	$75.86	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $38.02 / $97.72	Professional	26	$28.18	$38.02	$97.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $36.31 / $70.79	Professional	TC	$18.20	$36.31	$70.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Professional		$64.57	$64.57	$64.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $46.77 / $125.89	Professional		$37.15	$46.77	$125.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $30.90 / $67.61	Professional	26	$24.55	$30.90	$67.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $15.85 / $53.70	Professional	TC	$12.88	$15.85	$53.70
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $47.86 / $93.33	Professional		$44.67	$47.86	$93.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $35.48 / $50.12	Facility	26	$7.59	$35.48	$50.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $91.20 / $275.42	Professional		$60.26	$91.20	$275.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $51.29 / $141.25	Professional	26	$30.90	$51.29	$141.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $42.66 / $144.54	Professional	TC	$22.39	$42.66	$144.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $100.00 / $147.91	Professional		$75.86	$100.00	$147.91
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $45.71 / $66.07	Professional	26	$34.67	$45.71	$66.07
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $54.95 / $83.18	Professional	TC	$43.65	$54.95	$83.18
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $28.84 / $28.84	Facility	26	$28.84	$28.84	$28.84
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $85.11 / $138.04	Professional		$44.67	$85.11	$138.04
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $43.65 / $66.07	Professional	26	$26.92	$43.65	$66.07
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $44.67 / $75.86	Professional	TC	$15.85	$44.67	$75.86
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $85.11 / $177.83	Professional		$70.79	$85.11	$177.83
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $44.67 / $81.28	Professional	26	$37.15	$44.67	$81.28
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $40.74 / $95.50	Professional	TC	$33.11	$40.74	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $69.18 / $154.88	Professional		$50.12	$69.18	$154.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $36.31 / $83.18	Professional	26	$25.70	$36.31	$83.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.11 / $75.86	Professional	TC	$21.88	$33.11	$75.86
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $42.66 / $107.15	Facility	26	$25.12	$42.66	$107.15
Univera Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $87.10 / $177.83	Professional		$44.67	$87.10	$177.83
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $42.66 / $83.18	Professional	26	$26.30	$42.66	$83.18
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $44.67 / $83.18	Professional	TC	$15.85	$44.67	$83.18