Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.37 / $11.26 / $23.61	Facility	26	$6.37	$11.26	$23.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.57 / $31.49 / $79.98	Professional		$21.57	$31.49	$79.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.37 / $8.83 / $22.24	Professional	26	$6.37	$8.83	$22.24
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $65.27 / $67.67 / $130.55	Professional	50	$65.27	$67.67	$130.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.20 / $22.05 / $45.59	Professional	TC	$15.20	$22.05	$45.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.55 / $22.73 / $65.92	Professional		$21.55	$22.73	$65.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.99 / $6.99 / $15.12	Professional	26	$6.99	$6.99	$15.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $24.57 / $76.28	Professional		$19.05	$24.57	$76.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.76 / $6.24 / $19.50	Professional	26	$4.76	$6.24	$19.50
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $28.19 / $36.85 / $108.72	Professional	50	$28.19	$36.85	$108.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.02 / $18.32 / $52.81	Professional	TC	$14.02	$18.32	$52.81
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $12.72 / $32.36 / $45.08	Professional		$12.72	$32.36	$45.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.43 / $40.26 / $105.77	Professional		$24.43	$40.26	$105.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.25 / $11.63 / $25.87	Professional	26	$6.25	$11.63	$25.87
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.29 / $38.29 / $43.42	Professional	50	$38.29	$38.29	$43.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.44 / $30.86 / $85.60	Professional	TC	$17.44	$30.86	$85.60
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $29.58 / $38.92 / $67.20	Professional		$29.58	$38.92	$67.20
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.21 / $11.35 / $18.05	Professional	26	$8.21	$11.35	$18.05
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.86 / $32.39 / $52.28	Professional	TC	$24.86	$32.39	$52.28
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.45 / $40.40 / $68.62	Professional		$19.45	$40.40	$68.62
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.63 / $11.37 / $17.93	Professional	26	$4.63	$11.37	$17.93
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.82 / $28.28 / $50.69	Professional	TC	$14.82	$28.28	$50.69
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.76 / $33.54 / $78.27	Professional		$30.76	$33.54	$78.27
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.77 / $16.97 / $19.12	Professional	26	$8.77	$16.97	$19.12
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $61.52 / $85.86 / $156.52	Professional	50	$61.52	$85.86	$156.52
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $26.56 / $44.13 / $99.28	Professional		$26.56	$44.13	$99.28
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $6.34 / $11.21 / $24.79	Professional	26	$6.34	$11.21	$24.79
MVP Health Care Facility/Professional Professional Modifier 50 Low / Median / High Price $38.29 / $38.29 / $43.42	Professional	50	$38.29	$38.29	$43.42
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $18.21 / $29.44 / $75.91	Professional	TC	$18.21	$29.44	$75.91
United Facility/Professional Professional Modifier Low / Median / High Price $24.12 / $31.82 / $68.09	Professional		$24.12	$31.82	$68.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.81 / $8.66 / $20.68	Professional	26	$6.81	$8.66	$20.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.00 / $23.13 / $50.50	Professional	TC	$18.00	$23.13	$50.50
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $9.84 / $9.84 / $27.97	Facility	26	$9.84	$9.84	$27.97
Univera Facility/Professional Professional Modifier Low / Median / High Price $19.45 / $48.52 / $82.70	Professional		$19.45	$48.52	$82.70
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $4.63 / $13.04 / $23.40	Professional	26	$4.63	$13.04	$23.40
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $14.82 / $35.44 / $61.09	Professional	TC	$14.82	$35.44	$61.09