Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.50 / $115.03 / $615.38	Facility		$68.50	$115.03	$615.38
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.86 / $65.67 / $119.00	Facility	26	$42.86	$65.67	$119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.60 / $108.18 / $304.56	Professional		$41.60	$108.18	$304.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.40 / $59.25 / $111.26	Professional	26	$34.40	$59.25	$111.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.98 / $57.92 / $169.55	Professional	TC	$26.98	$57.92	$169.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.09 / $72.39 / $305.56	Professional		$57.09	$72.39	$305.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.39 / $40.69 / $108.74	Professional	26	$32.39	$40.69	$108.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.70 / $30.67 / $166.62	Professional	TC	$24.70	$30.67	$166.62
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $40.47 / $52.64 / $4,050.00	Facility		$40.47	$52.64	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $40.47 / $52.64 / $93.12	Professional		$40.47	$52.64	$93.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.95 / $71.95 / $14,648.00	Facility		$71.95	$71.95	$14,648.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.98 / $41.98 / $41.98	Facility	26	$41.98	$41.98	$41.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.46 / $187.78 / $490.52	Professional		$63.46	$187.78	$490.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.45 / $79.84 / $182.72	Professional	26	$35.45	$79.84	$182.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.50 / $73.58 / $265.20	Professional	TC	$28.50	$73.58	$265.20
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $33.03 / $138.00 / $332.00	Facility		$33.03	$138.00	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $74.36 / $95.94 / $140.62	Professional		$74.36	$95.94	$140.62
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.59 / $53.47 / $74.39	Professional	26	$41.59	$53.47	$74.39
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.72 / $42.47 / $56.53	Professional	TC	$32.72	$42.47	$56.53
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.68 / $104.15 / $216.98	Professional		$59.68	$104.15	$216.98
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.28 / $59.37 / $77.62	Professional	26	$34.28	$59.37	$77.62
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.41 / $44.34 / $141.15	Professional	TC	$25.41	$44.34	$141.15
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $78.18 / $78.18 / $78.18	Professional		$78.18	$78.18	$78.18
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $71.95 / $71.95 / $597.00	Facility		$71.95	$71.95	$597.00
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $41.98 / $41.98 / $41.98	Facility	26	$41.98	$41.98	$41.98
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $70.77 / $145.91 / $490.52	Professional		$70.77	$145.91	$490.52
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $37.90 / $72.31 / $172.88	Professional	26	$37.90	$72.31	$172.88
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $29.03 / $58.08 / $261.94	Professional	TC	$29.03	$58.08	$261.94
United Facility/Professional Facility Modifier Low / Median / High Price $767.00 / $2,744.00 / $4,840.00	Facility		$767.00	$2,744.00	$4,840.00
United Facility/Professional Professional Modifier Low / Median / High Price $57.97 / $88.86 / $295.94	Professional		$57.97	$88.86	$295.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.49 / $46.23 / $138.59	Professional	26	$33.49	$46.23	$138.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.08 / $35.51 / $160.30	Professional	TC	$25.08	$35.51	$160.30
Univera Facility/Professional Facility Modifier Low / Median / High Price $83.25 / $83.25 / $714.91	Facility		$83.25	$83.25	$714.91
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $47.52 / $47.52 / $279.35	Facility	26	$47.52	$47.52	$279.35
Univera Facility/Professional Professional Modifier Low / Median / High Price $63.93 / $97.64 / $216.98	Professional		$63.93	$97.64	$216.98
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $36.49 / $56.07 / $93.54	Professional	26	$36.49	$56.07	$93.54
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $27.43 / $41.57 / $141.15	Professional	TC	$27.43	$41.57	$141.15