Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.18 / $19.54 / $25.00	Facility	26	$19.18	$19.54	$25.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.06 / $80.64 / $182.26	Professional		$68.06	$80.64	$182.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $23.30 / $47.17	Professional	26	$17.82	$23.30	$47.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.22 / $58.40 / $103.58	Professional	TC	$50.22	$58.40	$103.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.29 / $83.29 / $83.29	Professional		$83.29	$83.29	$83.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.18 / $72.50 / $184.88	Professional		$57.18	$72.50	$184.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.21 / $19.29 / $48.20	Professional	26	$15.21	$19.29	$48.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.96 / $53.21 / $136.75	Professional	TC	$41.96	$53.21	$136.75
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $28.95 / $77.25 / $106.19	Professional		$28.95	$77.25	$106.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.32 / $23.32 / $23.32	Facility	26	$23.32	$23.32	$23.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $67.55 / $67.55	Professional		$67.55	$67.55	$67.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $18.45 / $18.45	Professional	26	$18.45	$18.45	$18.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.10 / $49.10 / $49.10	Professional	TC	$49.10	$49.10	$49.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $78.39 / $101.66 / $152.13	Professional		$78.39	$101.66	$152.13
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.54 / $28.89 / $42.40	Professional	26	$20.54	$28.89	$42.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $64.28 / $84.23 / $158.13	Professional	TC	$64.28	$84.23	$158.13
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.06 / $75.43 / $142.68	Professional		$61.06	$75.43	$142.68
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.82 / $20.78 / $39.75	Professional	26	$16.82	$20.78	$39.75
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.24 / $54.65 / $102.93	Professional	TC	$44.24	$54.65	$102.93
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $77.12 / $83.62 / $83.62	Professional		$77.12	$83.62	$83.62
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $16.95 / $17.94 / $24.67	Professional	26	$16.95	$17.94	$24.67
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.16 / $80.16 / $80.16	Professional		$80.16	$80.16	$80.16
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.95 / $23.28 / $49.69	Professional	26	$21.95	$23.28	$49.69
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $23.32 / $23.32 / $23.32	Facility	26	$23.32	$23.32	$23.32
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $80.64 / $190.96	Professional		$67.55	$80.64	$190.96
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $18.45 / $35.88	Professional	26	$18.45	$18.45	$35.88
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $49.10 / $49.10 / $95.75	Professional	TC	$49.10	$49.10	$95.75
United Facility/Professional Professional Modifier Low / Median / High Price $64.20 / $87.97 / $195.39	Professional		$64.20	$87.97	$195.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.39 / $22.75 / $50.23	Professional	26	$16.39	$22.75	$50.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.53 / $65.91 / $157.63	Professional	TC	$47.53	$65.91	$157.63
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $21.96 / $21.96 / $22.20	Facility	26	$21.96	$21.96	$22.20
Univera Facility/Professional Professional Modifier Low / Median / High Price $63.51 / $88.39 / $158.41	Professional		$63.51	$88.39	$158.41
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $16.86 / $24.35 / $43.63	Professional	26	$16.86	$24.35	$43.63
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $46.65 / $64.04 / $114.77	Professional	TC	$46.65	$64.04	$114.77