Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.28 / $34.65 / $56.67	Facility	26	$24.28	$34.65	$56.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.65 / $135.21 / $260.94	Professional		$101.65	$135.21	$260.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.27 / $32.06 / $62.26	Professional	26	$22.27	$32.06	$62.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.04 / $110.45 / $206.54	Professional	TC	$69.04	$110.45	$206.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.75 / $19.75 / $19.75	Professional	26	$19.75	$19.75	$19.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.49 / $123.61 / $328.05	Professional		$97.49	$123.61	$328.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.39 / $24.06 / $66.72	Professional	26	$18.39	$24.06	$66.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.08 / $98.21 / $267.74	Professional	TC	$79.08	$98.21	$267.74
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $36.04 / $148.86 / $184.91	Professional		$36.04	$148.86	$184.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.43 / $39.43 / $39.43	Facility	26	$39.43	$39.43	$39.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.54 / $265.37 / $583.46	Professional		$148.54	$265.37	$583.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.96 / $42.23 / $84.32	Professional	26	$22.96	$42.23	$84.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $122.46 / $218.89 / $515.25	Professional	TC	$122.46	$218.89	$515.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $154.52 / $200.88 / $291.45	Professional		$154.52	$200.88	$291.45
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.72 / $47.74 / $72.61	Professional	26	$36.72	$47.74	$72.61
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $126.06 / $156.36 / $234.53	Professional	TC	$126.06	$156.36	$234.53
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.05 / $147.27 / $274.83	Professional		$90.05	$147.27	$274.83
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.82 / $33.46 / $57.09	Professional	26	$21.82	$33.46	$57.09
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $56.36 / $123.23 / $222.58	Professional	TC	$56.36	$123.23	$222.58
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $113.59 / $113.59 / $120.27	Professional		$113.59	$113.59	$120.27
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.55 / $31.55 / $31.55	Professional	26	$31.55	$31.55	$31.55
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $39.43 / $39.43 / $39.43	Facility	26	$39.43	$39.43	$39.43
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $144.01 / $239.95 / $530.28	Professional		$144.01	$239.95	$530.28
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $24.76 / $37.89 / $82.49	Professional	26	$24.76	$37.89	$82.49
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $130.03 / $186.16 / $509.41	Professional	TC	$130.03	$186.16	$509.41
United Facility/Professional Professional Modifier Low / Median / High Price $141.16 / $196.56 / $430.33	Professional		$141.16	$196.56	$430.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.96 / $32.67 / $72.13	Professional	26	$23.96	$32.67	$72.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.66 / $163.05 / $359.53	Professional	TC	$120.66	$163.05	$359.53
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $29.09 / $29.09 / $104.48	Facility	26	$29.09	$29.09	$104.48
Univera Facility/Professional Professional Modifier Low / Median / High Price $128.86 / $162.03 / $331.22	Professional		$128.86	$162.03	$331.22
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $23.80 / $33.46 / $66.09	Professional	26	$23.80	$33.46	$66.09
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $105.06 / $131.22 / $268.24	Professional	TC	$105.06	$131.22	$268.24