Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.53 / $26.28 / $58.62	Facility	26	$19.53	$26.28	$58.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.99 / $36.86 / $82.38	Professional		$29.99	$36.86	$82.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.54 / $23.58 / $45.43	Professional	26	$19.54	$23.58	$45.43
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.00 / $17.45 / $23.88	Professional	52	$15.00	$17.45	$23.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.17 / $11.97 / $21.76	Professional	TC	$10.17	$11.97	$21.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.42 / $32.33 / $53.34	Professional		$29.42	$32.33	$53.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.85 / $21.15 / $41.24	Professional	26	$18.85	$21.15	$41.24
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $8.19 / $8.19 / $8.19	Professional	52	$8.19	$8.19	$8.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.56 / $32.64 / $64.70	Professional		$26.56	$32.64	$64.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.80 / $21.87 / $41.07	Professional	26	$17.80	$21.87	$41.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $8.76 / $10.88 / $21.51	Professional	TC	$8.76	$10.88	$21.51
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $15.18 / $31.91 / $47.09	Professional		$15.18	$31.91	$47.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.15 / $25.15 / $25.15	Facility	26	$25.15	$25.15	$25.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.08 / $48.68 / $104.97	Professional		$34.08	$48.68	$104.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.20 / $31.91 / $68.14	Professional	26	$22.20	$31.91	$68.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.96 / $16.93 / $36.44	Professional	TC	$11.96	$16.93	$36.44
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $36.08 / $46.90 / $70.58	Professional		$36.08	$46.90	$70.58
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.43 / $29.16 / $44.70	Professional	26	$22.43	$29.16	$44.70
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.14 / $17.98 / $27.41	Professional	TC	$14.14	$17.98	$27.41
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $20.60 / $20.60 / $20.60	Facility	26	$20.60	$20.60	$20.60
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.72 / $33.60 / $68.84	Professional		$25.72	$33.60	$68.84
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.75 / $27.35 / $46.76	Professional	26	$16.75	$27.35	$46.76
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $8.69 / $12.47 / $24.37	Professional	TC	$8.69	$12.47	$24.37
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $32.78 / $32.78 / $32.78	Professional		$32.78	$32.78	$32.78
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.20 / $41.33 / $80.88	Professional		$32.20	$41.33	$80.88
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.86 / $28.17 / $46.16	Professional	26	$27.86	$28.17	$46.16
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $25.15 / $25.15 / $25.15	Facility	26	$25.15	$25.15	$25.15
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $33.33 / $45.90 / $95.91	Professional		$33.33	$45.90	$95.91
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $23.32 / $30.92 / $61.75	Professional	26	$23.32	$30.92	$61.75
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $11.73 / $15.52 / $34.06	Professional	TC	$11.73	$15.52	$34.06
United Facility/Professional Professional Modifier Low / Median / High Price $28.60 / $37.79 / $75.98	Professional		$28.60	$37.79	$75.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.89 / $25.61 / $50.25	Professional	26	$18.89	$25.61	$50.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.55 / $12.61 / $25.66	Professional	TC	$9.55	$12.61	$25.66
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $20.60 / $27.35 / $29.61	Facility	26	$20.60	$27.35	$29.61
Univera Facility/Professional Professional Modifier Low / Median / High Price $27.90 / $42.66 / $86.72	Professional		$27.90	$42.66	$86.72
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $18.02 / $27.56 / $56.03	Professional	26	$18.02	$27.56	$56.03
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $9.72 / $15.01 / $30.69	Professional	TC	$9.72	$15.01	$30.69