Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $14.16 / $31.53	Facility	26	$10.47	$14.16	$31.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.33 / $46.22 / $105.23	Professional		$37.33	$46.22	$105.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.62 / $27.64	Professional	26	$10.47	$12.62	$27.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.85 / $32.86 / $57.68	Professional	TC	$26.85	$32.86	$57.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.11 / $41.72 / $50.18	Professional		$38.11	$41.72	$50.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.15 / $14.50 / $19.25	Professional	26	$10.15	$14.50	$19.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $44.73 / $79.41	Professional		$38.02	$44.73	$79.41
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.66 / $11.87 / $22.07	Professional	26	$9.66	$11.87	$22.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.35 / $33.36 / $58.44	Professional	TC	$28.35	$33.36	$58.44
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $17.19 / $44.30 / $61.50	Professional		$17.19	$44.30	$61.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.55 / $13.55 / $13.55	Facility	26	$13.55	$13.55	$13.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.65 / $64.45 / $138.47	Professional		$45.65	$64.45	$138.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $17.57 / $36.64	Professional	26	$12.02	$17.57	$36.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.22 / $46.70 / $101.73	Professional	TC	$33.22	$46.70	$101.73
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $47.90 / $62.08 / $94.67	Professional		$47.90	$62.08	$94.67
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.07 / $15.69 / $24.09	Professional	26	$12.07	$15.69	$24.09
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.36 / $46.86 / $71.45	Professional	TC	$37.36	$46.86	$71.45
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $11.10 / $11.10 / $11.10	Facility	26	$11.10	$11.10	$11.10
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.93 / $46.74 / $89.43	Professional		$33.93	$46.74	$89.43
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.01 / $12.77 / $25.19	Professional	26	$9.01	$12.77	$25.19
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.80 / $34.21 / $65.45	Professional	TC	$23.80	$34.21	$65.45
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $41.16 / $42.82 / $43.97	Professional		$41.16	$42.82	$43.97
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.82 / $53.98 / $104.01	Professional		$45.82	$53.98	$104.01
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.86 / $15.01 / $18.44	Professional	26	$12.86	$15.01	$18.44
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $13.55 / $13.55 / $13.55	Facility	26	$13.55	$13.55	$13.55
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $43.52 / $59.73 / $126.74	Professional		$43.52	$59.73	$126.74
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $12.67 / $16.70 / $33.36	Professional	26	$12.67	$16.70	$33.36
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $32.90 / $42.58 / $92.95	Professional	TC	$32.90	$42.58	$92.95
United Facility/Professional Professional Modifier Low / Median / High Price $38.03 / $48.71 / $97.71	Professional		$38.03	$48.71	$97.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.14 / $13.65 / $28.31	Professional	26	$10.14	$13.65	$28.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.38 / $36.76 / $77.47	Professional	TC	$27.38	$36.76	$77.47
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $11.10 / $14.74 / $25.77	Facility	26	$11.10	$14.74	$25.77
Univera Facility/Professional Professional Modifier Low / Median / High Price $36.22 / $55.06 / $112.63	Professional		$36.22	$55.06	$112.63
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $9.71 / $14.76 / $30.19	Professional	26	$9.71	$14.76	$30.19
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $26.52 / $40.31 / $82.44	Professional	TC	$26.52	$40.31	$82.44