Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.14 / $13.60 / $21.01	Facility	26	$11.14	$13.60	$21.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.06 / $108.70 / $220.71	Professional		$76.06	$108.70	$220.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.14 / $13.26 / $49.49	Professional	26	$11.14	$13.26	$49.49
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $38.38 / $48.20 / $200.48	Professional	52	$38.38	$48.20	$200.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.03 / $104.06 / $186.07	Professional	TC	$69.03	$104.06	$186.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.28 / $83.32 / $147.13	Professional		$64.28	$83.32	$147.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $8.77 / $18.02	Professional	26	$6.76	$8.77	$18.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.42 / $81.59 / $230.63	Professional		$62.42	$81.59	$230.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.38 / $11.90 / $28.47	Professional	26	$9.38	$11.90	$28.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.04 / $69.34 / $197.40	Professional	TC	$53.04	$69.34	$197.40
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $17.82 / $101.60 / $119.42	Professional		$17.82	$101.60	$119.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.54 / $13.54 / $13.54	Facility	26	$13.54	$13.54	$13.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.05 / $152.69 / $308.69	Professional		$81.05	$152.69	$308.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.85 / $18.51 / $41.23	Professional	26	$10.85	$18.51	$41.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.90 / $127.70 / $286.30	Professional	TC	$65.90	$127.70	$286.30
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $94.09 / $114.19 / $164.63	Professional		$94.09	$114.19	$164.63
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.19 / $16.07 / $24.38	Professional	26	$12.19	$16.07	$24.38
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $80.40 / $100.00 / $150.01	Professional	TC	$80.40	$100.00	$150.01
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.72 / $100.80 / $172.19	Professional		$72.72	$100.80	$172.19
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $14.56 / $24.84	Professional	26	$9.69	$14.56	$24.84
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $56.80 / $91.02 / $147.35	Professional	TC	$56.80	$91.02	$147.35
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $67.66 / $67.66 / $74.59	Professional		$67.66	$67.66	$74.59
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $8.22 / $8.22	Professional	26	$8.22	$8.22	$8.22
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.53 / $105.38 / $131.06	Professional		$102.53	$105.38	$131.06
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.93 / $15.07 / $28.93	Professional	26	$12.93	$15.07	$28.93
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $13.54 / $13.54 / $13.54	Facility	26	$13.54	$13.54	$13.54
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $83.27 / $129.47 / $288.87	Professional		$83.27	$129.47	$288.87
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $11.25 / $17.66 / $41.01	Professional	26	$11.25	$17.66	$41.01
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $71.66 / $100.79 / $263.44	Professional	TC	$71.66	$100.79	$263.44
United Facility/Professional Professional Modifier Low / Median / High Price $75.37 / $100.10 / $224.02	Professional		$75.37	$100.10	$224.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.77 / $14.38 / $32.65	Professional	26	$10.77	$14.38	$32.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.25 / $87.48 / $198.92	Professional	TC	$64.25	$87.48	$198.92
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $13.83 / $13.83 / $40.71	Facility	26	$13.83	$13.83	$40.71
Univera Facility/Professional Professional Modifier Low / Median / High Price $81.50 / $101.51 / $214.88	Professional		$81.50	$101.51	$214.88
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $14.64 / $31.78	Professional	26	$9.69	$14.64	$31.78
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $69.73 / $90.11 / $183.10	Professional	TC	$69.73	$90.11	$183.10