Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $24.55 / $74.13	Facility	26	$18.20	$24.55	$74.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $81.28 / $354.81	Professional		$52.48	$81.28	$354.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $23.99 / $100.00	Professional	26	$15.85	$23.99	$100.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $28.84 / $199.53 / $263.03	Professional	50	$28.84	$199.53	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $44.67 / $87.10	Professional	TC	$36.31	$44.67	$87.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $57.54 / $64.57	Professional		$51.29	$57.54	$64.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $20.89 / $24.55	Professional	26	$20.89	$20.89	$24.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $57.54 / $114.82	Professional		$45.71	$57.54	$114.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $18.20 / $33.88	Professional	26	$14.79	$18.20	$33.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $38.90 / $81.28	Professional	TC	$30.90	$38.90	$81.28
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $67.61 / $93.33	Professional		$26.30	$67.61	$93.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.37 / $20.42 / $29.51	Facility	26	$4.37	$20.42	$29.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $95.50 / $281.84	Professional		$51.29	$95.50	$281.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $28.18 / $72.44	Professional	26	$14.13	$28.18	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $67.61 / $186.21	Professional	TC	$36.31	$67.61	$186.21
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $100.00 / $134.90	Professional		$67.61	$100.00	$134.90
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $27.54 / $38.90	Professional	26	$18.62	$27.54	$38.90
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $72.44 / $95.50	Professional	TC	$50.12	$72.44	$95.50
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $60.26 / $128.82	Professional		$42.66	$60.26	$128.82
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $18.62 / $38.90	Professional	26	$14.45	$18.62	$38.90
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $41.69 / $91.20	Professional	TC	$30.20	$41.69	$91.20
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $70.79 / $147.91	Professional		$66.07	$70.79	$147.91
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $16.98 / $38.02	Professional	26	$16.98	$16.98	$38.02
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	50	$144.54	$144.54	$144.54
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $87.10 / $162.18	Professional		$72.44	$87.10	$162.18
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $25.70 / $47.86	Professional	26	$20.89	$25.70	$47.86
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $60.26 / $114.82	Professional	TC	$51.29	$60.26	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $70.79 / $169.82	Professional		$52.48	$70.79	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $20.42 / $50.12	Professional	26	$15.14	$20.42	$50.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $50.12 / $123.03	Professional	TC	$37.15	$50.12	$123.03
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $21.38 / $37.15	Facility	26	$11.75	$21.38	$37.15
Univera Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $64.57 / $154.88	Professional		$46.77	$64.57	$154.88
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $21.38 / $46.77	Professional	26	$14.45	$21.38	$46.77
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $45.71 / $109.65	Professional	TC	$32.36	$45.71	$109.65