Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.10 / $115.20 / $830.83	Facility		$26.10	$115.20	$830.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.91 / $10.67 / $27.41	Facility	26	$6.91	$10.67	$27.41
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.12 / $92.39 / $253.43	Facility	TC	$17.12	$92.39	$253.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.92 / $25.99 / $74.83	Professional		$15.92	$25.99	$74.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.91 / $9.51 / $30.60	Professional	26	$6.91	$9.51	$30.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.59 / $13.84 / $29.76	Professional	TC	$8.59	$13.84	$29.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.09 / $17.98 / $20.55	Professional		$17.09	$17.98	$20.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.42 / $7.81 / $17.84	Professional	26	$6.42	$7.81	$17.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.14 / $25.55 / $60.34	Professional		$20.14	$25.55	$60.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.45 / $8.44 / $19.91	Professional	26	$6.45	$8.44	$19.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.70 / $16.82 / $34.17	Professional	TC	$13.70	$16.82	$34.17
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $12.72 / $12.72 / $23.29	Facility		$12.72	$12.72	$23.29
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $12.72 / $23.29 / $36.01	Professional		$12.72	$23.29	$36.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.25 / $56.06 / $90.51	Facility		$32.25	$56.06	$90.51
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 Facility Modifier TC Low / Median / High Price $19.39 / $19.39 / $19.39	Facility	TC	$19.39	$19.39	$19.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.26 / $31.71 / $76.23	Professional		$19.26	$31.71	$76.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.37 / $11.93 / $26.04	Professional	26	$6.37	$11.93	$26.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.27 / $20.05 / $52.52	Professional	TC	$11.27	$20.05	$52.52
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $14.74 / $26.22 / $332.00	Facility		$14.74	$26.22	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $22.34 / $30.61 / $53.02	Professional		$22.34	$30.61	$53.02
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 $17.73 / $23.04 / $37.32	Professional	TC	$17.73	$23.04	$37.32
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $10.10 / $10.10 / $10.10	Facility		$10.10	$10.10	$10.10
Excellus BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $6.06 / $6.06 / $6.06	Facility	TC	$6.06	$6.06	$6.06
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.01 / $30.13 / $53.99	Professional		$17.01	$30.13	$53.99
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.23 / $11.37 / $17.93	Professional	26	$7.23	$11.37	$17.93
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.10 / $20.12 / $36.06	Professional	TC	$9.10	$20.12	$36.06
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $26.61 / $28.09 / $28.45	Professional		$26.61	$28.09	$28.45
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $7.32 / $9.09 / $10.32	Professional	26	$7.32	$9.09	$10.32
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.54 / $137.13 / $299.07	Facility		$42.54	$137.13	$299.07
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $16.91 / $86.70 / $297.47	Facility	TC	$16.91	$86.70	$297.47
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.10 / $24.66 / $34.13	Professional		$24.10	$24.66	$34.13
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.23 / $10.92 / $21.21	Professional	26	$9.23	$10.92	$21.21
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $30.62 / $56.25 / $190.23	Facility		$30.62	$56.25	$190.23
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 Facility Modifier TC Low / Median / High Price $19.39 / $19.39 / $19.39	Facility	TC	$19.39	$19.39	$19.39
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $17.45 / $32.04 / $67.33	Professional		$17.45	$32.04	$67.33
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $11.90 / $26.04	Professional	26	$6.74	$11.90	$26.04
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $11.72 / $20.59 / $48.76	Professional	TC	$11.72	$20.59	$48.76
United Facility/Professional Professional Modifier Low / Median / High Price $19.54 / $25.98 / $60.88	Professional		$19.54	$25.98	$60.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.37 / $9.77 / $24.33	Professional	26	$7.37	$9.77	$24.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.57 / $16.48 / $34.42	Professional	TC	$12.57	$16.48	$34.42
Univera Facility/Professional Facility Modifier Low / Median / High Price $29.63 / $29.63 / $30.07	Facility		$29.63	$29.63	$30.07
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $9.84 / $9.84 / $14.13	Facility	26	$9.84	$9.84	$14.13
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $15.72 / $19.79 / $19.79	Facility	TC	$15.72	$19.79	$19.79
Univera Facility/Professional Professional Modifier Low / Median / High Price $17.01 / $38.28 / $65.06	Professional		$17.01	$38.28	$65.06
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $7.75 / $13.04 / $21.61	Professional	26	$7.75	$13.04	$21.61
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $9.26 / $25.18 / $43.46	Professional	TC	$9.26	$25.18	$43.46