Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.23 / $56.89 / $237.24	Facility		$30.23	$56.89	$237.24
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.98 / $12.23 / $23.61	Facility	26	$8.98	$12.23	$23.61
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.90 / $60.24 / $175.38	Facility	TC	$22.90	$60.24	$175.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.79 / $37.21 / $94.16	Professional		$27.79	$37.21	$94.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.84 / $11.28 / $26.52	Professional	26	$7.84	$11.28	$26.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.27 / $25.92 / $51.26	Professional	TC	$18.27	$25.92	$51.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.06 / $28.30 / $36.45	Professional		$27.06	$28.30	$36.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.84 / $8.26 / $12.39	Professional	26	$4.84	$8.26	$12.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.10 / $34.93 / $91.51	Professional		$27.10	$34.93	$91.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.15 / $8.03 / $25.19	Professional	26	$6.15	$8.03	$25.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.57 / $26.08 / $59.75	Professional	TC	$20.57	$26.08	$59.75
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $12.72 / $12.72 / $37.14	Facility		$12.72	$12.72	$37.14
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $12.72 / $37.14 / $49.86	Professional		$12.72	$37.14	$49.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.32 / $88.73 / $230.79	Facility		$55.32	$88.73	$230.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $30.58 / $30.58 / $30.58	Facility	TC	$30.58	$30.58	$30.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.14 / $52.09 / $128.59	Professional		$28.14	$52.09	$128.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.81 / $15.27 / $30.52	Professional	26	$6.81	$15.27	$30.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.88 / $38.42 / $98.07	Professional	TC	$20.88	$38.42	$98.07
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $23.20 / $41.68 / $332.00	Facility		$23.20	$41.68	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $33.64 / $44.97 / $73.28	Professional		$33.64	$44.97	$73.28
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 $27.92 / $36.40 / $58.67	Professional	TC	$27.92	$36.40	$58.67
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $15.15 / $15.15 / $15.15	Facility		$15.15	$15.15	$15.15
Excellus BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $9.09 / $9.09 / $9.09	Facility	TC	$9.09	$9.09	$9.09
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.15 / $42.17 / $75.58	Professional		$25.15	$42.17	$75.58
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.68 / $11.49 / $18.63	Professional	26	$6.68	$11.49	$18.63
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $31.78 / $56.96	Professional	TC	$18.48	$31.78	$56.96
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $119.87 / $337.95	Facility		$65.00	$119.87	$337.95
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $64.55 / $80.23 / $402.50	Facility	TC	$64.55	$80.23	$402.50
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.31 / $46.64 / $48.00	Professional		$33.31	$46.64	$48.00
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.73 / $13.74 / $21.21	Professional	26	$9.73	$13.74	$21.21
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $47.00 / $88.77 / $256.44	Facility		$47.00	$88.77	$256.44
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
MVP Health Care Facility/Professional Facility Modifier TC Low / Median / High Price $30.58 / $30.58 / $30.58	Facility	TC	$30.58	$30.58	$30.58
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $31.26 / $49.43 / $116.15	Professional		$31.26	$49.43	$116.15
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $7.38 / $14.29 / $30.18	Professional	26	$7.38	$14.29	$30.18
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $21.51 / $33.59 / $86.43	Professional	TC	$21.51	$33.59	$86.43
United Facility/Professional Facility Modifier Low / Median / High Price $206.32 / $243.08 / $320.81	Facility		$206.32	$243.08	$320.81
United Facility/Professional Professional Modifier Low / Median / High Price $29.47 / $36.45 / $77.01	Professional		$29.47	$36.45	$77.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.72 / $10.47 / $22.59	Professional	26	$7.72	$10.47	$22.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.78 / $26.90 / $54.07	Professional	TC	$21.78	$26.90	$54.07
Univera Facility/Professional Facility Modifier Low / Median / High Price $41.48 / $41.48 / $110.61	Facility		$41.48	$41.48	$110.61
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $10.22 / $10.22 / $38.65	Facility	26	$10.22	$10.22	$38.65
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $31.26 / $31.26 / $76.42	Facility	TC	$31.26	$31.26	$76.42
Univera Facility/Professional Professional Modifier Low / Median / High Price $25.15 / $52.91 / $93.72	Professional		$25.15	$52.91	$93.72
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $6.68 / $13.04 / $23.40	Professional	26	$6.68	$13.04	$23.40
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $39.86 / $71.70	Professional	TC	$18.48	$39.86	$71.70