Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.65 / $30.54 / $49.36	Facility	26	$24.65	$30.54	$49.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.47 / $64.53 / $127.58	Professional		$52.47	$64.53	$127.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.65 / $29.57 / $67.27	Professional	26	$24.65	$29.57	$67.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.81 / $34.90 / $62.65	Professional	TC	$27.81	$34.90	$62.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.25 / $54.25 / $58.39	Professional		$54.25	$54.25	$58.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.50 / $44.54 / $51.40	Professional	26	$23.50	$44.54	$51.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.10 / $58.50 / $111.79	Professional		$47.10	$58.50	$111.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.46 / $27.89 / $52.24	Professional	26	$22.46	$27.89	$52.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.64 / $30.60 / $61.53	Professional	TC	$24.64	$30.60	$61.53
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $40.29 / $47.17 / $87.46	Professional		$40.29	$47.17	$87.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.36 / $31.36 / $31.36	Facility	26	$31.36	$31.36	$31.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.73 / $90.84 / $207.84	Professional		$61.73	$90.84	$207.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.74 / $40.47 / $85.88	Professional	26	$27.74	$40.47	$85.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.85 / $49.48 / $117.99	Professional	TC	$33.85	$49.48	$117.99
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $67.02 / $86.46 / $131.85	Professional		$67.02	$86.46	$131.85
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.92 / $36.29 / $55.79	Professional	26	$27.92	$36.29	$55.79
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.65 / $51.32 / $78.27	Professional	TC	$40.65	$51.32	$78.27
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $25.71 / $25.71 / $25.71	Facility	26	$25.71	$25.71	$25.71
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.66 / $66.27 / $126.78	Professional		$43.66	$66.27	$126.78
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.12 / $34.14 / $58.35	Professional	26	$21.12	$34.14	$58.35
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $37.25 / $71.27	Professional	TC	$24.55	$37.25	$71.27
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.53 / $146.53 / $146.53	Professional		$146.53	$146.53	$146.53
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.03 / $35.57 / $46.53	Professional	26	$34.03	$35.57	$46.53
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $31.36 / $31.36 / $31.36	Facility	26	$31.36	$31.36	$31.36
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $62.47 / $85.00 / $180.86	Professional		$62.47	$85.00	$180.86
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $28.76 / $38.70 / $76.92	Professional	26	$28.76	$38.70	$76.92
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $32.40 / $43.61 / $98.22	Professional	TC	$32.40	$43.61	$98.22
United Facility/Professional Professional Modifier Low / Median / High Price $51.23 / $69.54 / $163.26	Professional		$51.23	$69.54	$163.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.38 / $31.60 / $65.78	Professional	26	$23.38	$31.60	$65.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.53 / $36.39 / $75.26	Professional	TC	$26.53	$36.39	$75.26
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $25.71 / $34.14 / $113.04	Facility	26	$25.71	$34.14	$113.04
Univera Facility/Professional Professional Modifier Low / Median / High Price $47.98 / $78.06 / $159.69	Professional		$47.98	$78.06	$159.69
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $21.12 / $34.18 / $70.31	Professional	26	$21.12	$34.18	$70.31
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $26.86 / $43.88 / $89.77	Professional	TC	$26.86	$43.88	$89.77