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 / $51.29	Facility	26	$25.70	$33.11	$51.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $72.44 / $194.98	Professional		$56.23	$72.44	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $43.65 / $102.33	Professional	26	$25.70	$43.65	$102.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $34.67 / $83.18	Professional	TC	$28.84	$34.67	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $64.57 / $67.61	Professional		$58.88	$64.57	$67.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $54.95 / $109.65	Professional		$46.77	$54.95	$109.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $26.30 / $48.98	Professional	26	$22.39	$26.30	$48.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $28.84 / $60.26	Professional	TC	$24.55	$28.84	$60.26
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $46.77 / $87.10	Professional		$40.74	$46.77	$87.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.61 / $30.90 / $44.67	Facility	26	$6.61	$30.90	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $91.20 / $218.78	Professional		$63.10	$91.20	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $40.74 / $89.13	Professional	26	$27.54	$40.74	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $48.98 / $128.82	Professional	TC	$33.88	$48.98	$128.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $100.00 / $144.54	Professional		$81.28	$100.00	$144.54
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $42.66 / $61.66	Professional	26	$32.36	$42.66	$61.66
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $63.10 / $85.11	Professional	TC	$47.86	$63.10	$85.11
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $25.70 / $25.70	Facility	26	$25.70	$25.70	$25.70
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $67.61 / $131.83	Professional		$43.65	$67.61	$131.83
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $33.88 / $58.88	Professional	26	$20.89	$33.88	$58.88
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $38.02 / $74.13	Professional	TC	$24.55	$38.02	$74.13
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $74.13 / $147.91	Professional		$50.12	$74.13	$147.91
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $35.48 / $58.88	Professional	26	$35.48	$35.48	$58.88
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $81.28 / $165.96	Professional		$67.61	$81.28	$165.96
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $38.90 / $72.44	Professional	26	$32.36	$38.90	$72.44
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $42.66 / $93.33	Professional	TC	$35.48	$42.66	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $67.61 / $158.49	Professional		$50.12	$67.61	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $30.90 / $64.57	Professional	26	$22.91	$30.90	$64.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $36.31 / $75.86	Professional	TC	$26.30	$36.31	$75.86
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $22.39 / $33.88 / $112.20	Facility	26	$22.39	$33.88	$112.20
Univera Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $77.62 / $154.88	Professional		$47.86	$77.62	$154.88
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $33.88 / $70.79	Professional	26	$21.38	$33.88	$70.79
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $43.65 / $87.10	Professional	TC	$26.92	$43.65	$87.10