Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.07 / $56.54 / $79.06	Facility	26	$43.07	$56.54	$79.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.51 / $86.84 / $130.85	Professional		$75.51	$86.84	$130.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.81 / $45.60 / $67.47	Professional	26	$38.81	$45.60	$67.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.82 / $41.90 / $63.20	Professional	TC	$34.82	$41.90	$63.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.87 / $94.86 / $102.17	Professional		$70.87	$94.86	$102.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $69.05 / $160.11	Professional		$53.70	$69.05	$160.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.23 / $38.21 / $84.08	Professional	26	$29.23	$38.21	$84.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.92 / $31.03 / $79.58	Professional	TC	$23.92	$31.03	$79.58
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $61.97 / $64.16 / $126.13	Professional		$61.97	$64.16	$126.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $50.00 / $50.00	Facility	26	$50.00	$50.00	$50.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.44 / $123.69 / $296.24	Professional		$67.44	$123.69	$296.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.72 / $66.06 / $151.34	Professional	26	$33.72	$66.06	$151.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.64 / $60.23 / $152.30	Professional	TC	$31.64	$60.23	$152.30
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $91.12 / $122.88 / $175.14	Professional		$91.12	$122.88	$175.14
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.92 / $59.71 / $89.36	Professional	26	$44.92	$59.71	$89.36
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.82 / $65.89 / $87.78	Professional	TC	$50.82	$65.89	$87.78
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.67 / $86.76 / $201.38	Professional		$71.67	$86.76	$201.38
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.58 / $47.15 / $101.21	Professional	26	$35.58	$47.15	$101.21
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.10 / $45.26 / $100.17	Professional	TC	$35.10	$45.26	$100.17
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $55.70 / $82.17 / $87.77	Professional		$55.70	$82.17	$87.77
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $50.00 / $50.00	Facility	26	$50.00	$50.00	$50.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $65.98 / $123.23 / $272.08	Professional		$65.98	$123.23	$272.08
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $34.86 / $64.04 / $143.01	Professional	26	$34.86	$64.04	$143.01
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $33.65 / $58.73 / $141.32	Professional	TC	$33.65	$58.73	$141.32
United Facility/Professional Professional Modifier Low / Median / High Price $69.76 / $97.34 / $235.59	Professional		$69.76	$97.34	$235.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.26 / $51.17 / $116.60	Professional	26	$37.26	$51.17	$116.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.15 / $48.57 / $114.95	Professional	TC	$35.15	$48.57	$114.95
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $51.52 / $51.52 / $165.94	Facility	26	$51.52	$51.52	$165.94
Univera Facility/Professional Professional Modifier Low / Median / High Price $73.09 / $103.11 / $224.07	Professional		$73.09	$103.11	$224.07
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $36.02 / $52.61 / $112.62	Professional	26	$36.02	$52.61	$112.62
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $37.53 / $50.99 / $111.46	Professional	TC	$37.53	$50.99	$111.46