Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.39 / $115.20 / $590.59	Facility		$34.39	$115.20	$590.59
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.21 / $11.69 / $23.41	Facility	26	$8.21	$11.69	$23.41
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.36 / $128.36 / $287.48	Facility	TC	$29.36	$128.36	$287.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.26 / $36.24 / $95.79	Professional		$23.26	$36.24	$95.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.21 / $12.00 / $38.51	Professional	26	$8.21	$12.00	$38.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.41 / $22.73 / $47.28	Professional	TC	$15.41	$22.73	$47.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.04 / $26.18 / $31.82	Professional		$22.04	$26.18	$31.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.69 / $9.85 / $20.23	Professional	26	$7.69	$9.85	$20.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.04 / $33.02 / $82.08	Professional		$26.04	$33.02	$82.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.61 / $9.94 / $23.84	Professional	26	$7.61	$9.94	$23.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.42 / $22.88 / $50.69	Professional	TC	$18.42	$22.88	$50.69
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $15.19 / $15.19 / $31.89	Facility		$15.19	$15.19	$31.89
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $15.19 / $31.89 / $47.08	Professional		$15.19	$31.89	$47.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.25 / $76.36 / $110.34	Facility		$47.25	$76.36	$110.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $11.95	Facility	26	$11.95	$11.95	$11.95
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.10 / $26.10 / $26.10	Facility	TC	$26.10	$26.10	$26.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.06 / $44.60 / $102.91	Professional		$25.06	$44.60	$102.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.57 / $14.36 / $31.27	Professional	26	$7.57	$14.36	$31.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.52 / $29.99 / $71.88	Professional	TC	$17.52	$29.99	$71.88
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $19.80 / $35.34 / $332.00	Facility		$19.80	$35.34	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $31.23 / $40.98 / $68.70	Professional		$31.23	$40.98	$68.70
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.81 / $13.45 / $21.58	Professional	26	$9.81	$13.45	$21.58
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.85 / $31.06 / $50.14	Professional	TC	$23.85	$31.06	$50.14
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 $26.13 / $39.54 / $70.86	Professional		$26.13	$39.54	$70.86
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.65 / $13.73 / $22.26	Professional	26	$8.65	$13.73	$22.26
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.77 / $27.12 / $48.60	Professional	TC	$16.77	$27.12	$48.60
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $28.59 / $34.46 / $62.67	Professional		$28.59	$34.46	$62.67
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $7.69 / $8.90 / $10.57	Professional	26	$7.69	$8.90	$10.57
Fidelis Facility/Professional Professional Modifier TC Low / Median / High Price $21.26 / $21.26 / $21.26	Professional	TC	$21.26	$21.26	$21.26
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.24 / $112.61 / $347.99	Facility		$27.24	$112.61	$347.99
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $22.79 / $84.62 / $321.19	Facility	TC	$22.79	$84.62	$321.19
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.15 / $43.16 / $79.38	Professional		$32.15	$43.16	$79.38
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.15 / $13.58 / $25.24	Professional	26	$11.15	$13.58	$25.24
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.00 / $54.48 / $55.46	Professional	TC	$21.00	$54.48	$55.46
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $41.10 / $76.41 / $216.85	Facility		$41.10	$76.41	$216.85
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $11.95	Facility	26	$11.95	$11.95	$11.95
MVP Health Care Facility/Professional Facility Modifier TC Low / Median / High Price $26.10 / $26.10 / $26.10	Facility	TC	$26.10	$26.10	$26.10
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $26.87 / $44.02 / $94.32	Professional		$26.87	$44.02	$94.32
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $14.13 / $30.72	Professional	26	$8.02	$14.13	$30.72
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $17.70 / $29.01 / $64.84	Professional	TC	$17.70	$29.01	$64.84
United Facility/Professional Professional Modifier Low / Median / High Price $27.13 / $33.20 / $69.94	Professional		$27.13	$33.20	$69.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.74 / $11.48 / $28.54	Professional	26	$8.74	$11.48	$28.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.03 / $22.95 / $52.09	Professional	TC	$18.03	$22.95	$52.09
Univera Facility/Professional Facility Modifier Low / Median / High Price $38.88 / $38.88 / $46.25	Facility		$38.88	$38.88	$46.25
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $12.21 / $12.21 / $16.94	Facility	26	$12.21	$12.21	$16.94
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $26.67 / $26.67 / $29.35	Facility	TC	$26.67	$26.67	$29.35
Univera Facility/Professional Professional Modifier Low / Median / High Price $26.13 / $49.60 / $85.39	Professional		$26.13	$49.60	$85.39
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $9.22 / $15.58 / $26.82	Professional	26	$9.22	$15.58	$26.82
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $16.91 / $34.02 / $58.57	Professional	TC	$16.91	$34.02	$58.57