Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $56.23 / $85.11	Facility	26	$38.02	$56.23	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $85.11 / $204.17	Professional		$64.57	$85.11	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $50.12 / $123.03	Professional	26	$33.88	$50.12	$123.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $36.31 / $74.13	Professional	TC	$19.05	$36.31	$74.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $66.07 / $69.18	Professional		$63.10	$66.07	$69.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $52.48 / $144.54	Professional		$42.66	$52.48	$144.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $36.31 / $81.28	Professional	26	$28.84	$36.31	$81.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $16.22 / $56.23	Professional	TC	$13.18	$16.22	$56.23
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $52.48 / $100.00	Professional		$47.86	$52.48	$100.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.71 / $40.74 / $57.54	Facility	26	$8.71	$40.74	$57.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $109.65 / $323.59	Professional		$69.18	$109.65	$323.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $64.57 / $165.96	Professional	26	$36.31	$64.57	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $44.67 / $144.54	Professional	TC	$25.12	$44.67	$144.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $107.15 / $158.49	Professional		$81.28	$107.15	$158.49
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $52.48 / $75.86	Professional	26	$39.81	$52.48	$75.86
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $54.95 / $83.18	Professional	TC	$42.66	$54.95	$83.18
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $33.88 / $33.88 / $33.88	Facility	26	$33.88	$33.88	$33.88
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $89.13 / $147.91	Professional		$52.48	$89.13	$147.91
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $50.12 / $75.86	Professional	26	$33.11	$50.12	$75.86
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $44.67 / $74.13	Professional	TC	$17.78	$44.67	$74.13
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $91.20 / $190.55	Professional		$75.86	$91.20	$190.55
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $52.48 / $95.50	Professional	26	$43.65	$52.48	$95.50
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $40.74 / $93.33	Professional	TC	$33.11	$40.74	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $74.13 / $165.96	Professional		$56.23	$74.13	$165.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $42.66 / $95.50	Professional	26	$30.20	$42.66	$95.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $33.88 / $75.86	Professional	TC	$23.44	$33.88	$75.86
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $50.12 / $141.25	Facility	26	$29.51	$50.12	$141.25
Univera Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $97.72 / $208.93	Professional		$53.70	$97.72	$208.93
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $50.12 / $97.72	Professional	26	$30.90	$50.12	$97.72
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $44.67 / $83.18	Professional	TC	$17.78	$44.67	$83.18