Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $33.11 / $91.20	Facility	26	$25.70	$33.11	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $67.61 / $165.96	Professional		$40.74	$67.61	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $33.11 / $91.20	Professional	26	$21.88	$33.11	$91.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $33.11 / $67.61	Professional	TC	$16.60	$33.11	$67.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Professional		$57.54	$57.54	$57.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $40.74 / $107.15	Professional		$33.11	$40.74	$107.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $25.70 / $56.23	Professional	26	$20.42	$25.70	$56.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $15.49 / $51.29	Professional	TC	$12.59	$15.49	$51.29
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $46.77 / $83.18	Professional		$37.15	$46.77	$83.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $28.18 / $40.74	Facility	26	$6.03	$28.18	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $79.43 / $239.88	Professional		$52.48	$79.43	$239.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $41.69 / $114.82	Professional	26	$25.12	$41.69	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $40.74 / $138.04	Professional	TC	$20.89	$40.74	$138.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $89.13 / $134.90	Professional		$67.61	$89.13	$134.90
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $37.15 / $53.70	Professional	26	$28.18	$37.15	$53.70
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $52.48 / $79.43	Professional	TC	$41.69	$52.48	$79.43
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $23.44 / $23.44	Facility	26	$23.44	$23.44	$23.44
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $74.13 / $123.03	Professional		$37.15	$74.13	$123.03
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $34.67 / $53.70	Professional	26	$21.38	$34.67	$53.70
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $42.66 / $72.44	Professional	TC	$14.13	$42.66	$72.44
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $74.13 / $158.49	Professional		$61.66	$74.13	$158.49
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $36.31 / $66.07	Professional	26	$30.20	$36.31	$66.07
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $38.90 / $91.20	Professional	TC	$31.62	$38.90	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $60.26 / $138.04	Professional		$43.65	$60.26	$138.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $29.51 / $67.61	Professional	26	$21.38	$29.51	$67.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $31.62 / $72.44	Professional	TC	$20.89	$31.62	$72.44
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $34.67 / $85.11	Facility	26	$20.42	$34.67	$85.11
Univera Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $74.13 / $151.36	Professional		$37.15	$74.13	$151.36
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $34.67 / $64.57	Professional	26	$20.42	$34.67	$64.57
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $42.66 / $79.43	Professional	TC	$14.13	$42.66	$79.43