Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.28 / $18.00 / $36.08	Facility	26	$13.28	$18.00	$36.08
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.82 / $50.37 / $157.13	Facility	TC	$26.82	$50.37	$157.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.18 / $47.25 / $113.67	Professional		$35.18	$47.25	$113.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.08 / $15.33 / $36.08	Professional	26	$12.08	$15.33	$36.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.90 / $31.62 / $60.88	Professional	TC	$21.90	$31.62	$60.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.49 / $33.49 / $35.02	Professional		$33.49	$33.49	$35.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.05 / $10.05 / $10.05	Professional	26	$10.05	$10.05	$10.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.94 / $46.99 / $115.90	Professional		$35.94	$46.99	$115.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.93 / $17.61 / $36.25	Professional	26	$13.93	$17.61	$36.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.01 / $28.78 / $72.80	Professional	TC	$22.01	$28.78	$72.80
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $19.63 / $43.35 / $62.97	Professional		$19.63	$43.35	$62.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.41 / $15.41 / $15.41	Facility	26	$15.41	$15.41	$15.41
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.04 / $35.04 / $35.04	Facility	TC	$35.04	$35.04	$35.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.47 / $64.06 / $156.00	Professional		$35.47	$64.06	$156.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.42 / $21.20 / $46.13	Professional	26	$10.42	$21.20	$46.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.65 / $45.99 / $114.27	Professional	TC	$24.65	$45.99	$114.27
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $45.13 / $59.77 / $91.21	Professional		$45.13	$59.77	$91.21
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.67 / $17.29 / $27.87	Professional	26	$12.67	$17.29	$27.87
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.00 / $41.73 / $67.20	Professional	TC	$32.00	$41.73	$67.20
Excellus BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $15.15 / $15.15 / $15.15	Facility	TC	$15.15	$15.15	$15.15
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.98 / $52.49 / $94.07	Professional		$31.98	$52.49	$94.07
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.08 / $17.73 / $28.75	Professional	26	$9.08	$17.73	$28.75
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $36.45 / $65.31	Professional	TC	$22.91	$36.45	$65.31
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $43.96 / $132.13 / $770.60	Facility	TC	$43.96	$132.13	$770.60
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.43 / $59.73 / $84.46	Professional		$50.43	$59.73	$84.46
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.68 / $24.91 / $29.09	Professional	26	$19.68	$24.91	$29.09
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $15.41 / $15.41 / $15.41	Facility	26	$15.41	$15.41	$15.41
MVP Health Care Facility/Professional Facility Modifier TC Low / Median / High Price $35.04 / $35.04 / $35.04	Facility	TC	$35.04	$35.04	$35.04
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $39.47 / $61.04 / $145.30	Professional		$39.47	$61.04	$145.30
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $11.35 / $20.02 / $42.83	Professional	26	$11.35	$20.02	$42.83
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $24.81 / $39.93 / $100.01	Professional	TC	$24.81	$39.93	$100.01
United Facility/Professional Professional Modifier Low / Median / High Price $37.08 / $48.22 / $99.79	Professional		$37.08	$48.22	$99.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.58 / $15.48 / $38.99	Professional	26	$11.58	$15.48	$38.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.39 / $32.34 / $69.63	Professional	TC	$25.39	$32.34	$69.63
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $15.78 / $15.78 / $54.37	Facility	26	$15.78	$15.78	$54.37
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $35.84 / $35.84 / $105.25	Facility	TC	$35.84	$35.84	$105.25
Univera Facility/Professional Professional Modifier Low / Median / High Price $31.98 / $65.84 / $118.34	Professional		$31.98	$65.84	$118.34
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $9.08 / $20.13 / $36.11	Professional	26	$9.08	$20.13	$36.11
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $45.72 / $82.23	Professional	TC	$22.91	$45.72	$82.23