Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.78 / $23.44 / $40.74	Facility	26	$17.78	$23.44	$40.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $57.54 / $234.42	Professional		$39.81	$57.54	$234.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $30.90 / $72.44	Professional	26	$22.91	$30.90	$72.44
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $33.11 / $309.03 / $323.59	Professional	52	$33.11	$309.03	$323.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $22.91 / $72.44	Professional	TC	$15.85	$22.91	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $34.67 / $74.13	Professional		$30.20	$34.67	$74.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $38.02 / $66.07	Professional	26	$22.91	$38.02	$66.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $54.95 / $107.15	Professional		$44.67	$54.95	$107.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $29.51 / $57.54	Professional	26	$24.55	$29.51	$57.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $25.12 / $46.77	Professional	TC	$20.89	$25.12	$46.77
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $41.69 / $77.62	Professional		$34.67	$41.69	$77.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.61 / $30.90 / $43.65	Facility	26	$6.61	$30.90	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $93.33	Professional		$38.90	$38.90	$93.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $25.12 / $58.88	Professional	26	$25.12	$25.12	$58.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $14.13 / $50.12	Professional	TC	$14.13	$14.13	$50.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $61.66 / $79.43	Professional		$43.65	$61.66	$79.43
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $45.71 / $57.54	Professional	26	$30.90	$45.71	$57.54
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $19.95 / $26.30	Professional	TC	$13.80	$19.95	$26.30
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $66.07 / $120.23	Professional		$41.69	$66.07	$120.23
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $42.66 / $70.79	Professional	26	$26.92	$42.66	$70.79
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $22.91 / $47.86	Professional	TC	$15.49	$22.91	$47.86
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $64.57 / $107.15	Professional		$47.86	$64.57	$107.15
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $42.66 / $70.79	Professional	26	$30.20	$42.66	$70.79
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $75.86 / $125.89	Professional		$63.10	$75.86	$125.89
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $40.74 / $75.86	Professional	26	$33.88	$40.74	$75.86
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $33.88 / $54.95	Professional	TC	$27.54	$33.88	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $56.23 / $109.65	Professional		$37.15	$56.23	$109.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $30.90 / $60.26	Professional	26	$20.89	$30.90	$60.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $25.12 / $51.29	Professional	TC	$14.79	$25.12	$51.29
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $30.20 / $30.90	Facility	26	$23.44	$30.20	$30.90
Univera Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $57.54 / $120.23	Professional		$38.90	$57.54	$120.23
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $36.31 / $72.44	Professional	26	$23.44	$36.31	$72.44
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $22.39 / $47.86	Professional	TC	$15.49	$22.39	$47.86