Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $107.15 / $562.34	Facility		$36.31	$107.15	$562.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $11.22 / $24.55	Facility	26	$8.13	$11.22	$24.55
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.51 / $97.72 / $323.59	Facility	TC	$29.51	$97.72	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $43.65 / $128.82	Professional		$26.30	$43.65	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.13 / $43.65	Professional	26	$8.91	$14.13	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $27.54 / $69.18	Professional	TC	$17.78	$27.54	$69.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $27.54 / $52.48	Professional		$22.91	$27.54	$52.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $11.48 / $23.44	Professional	26	$5.75	$11.48	$23.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $21.88 / $39.81	Professional	TC	$15.14	$21.88	$39.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $32.36 / $75.86	Professional		$26.30	$32.36	$75.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.33 / $21.38	Professional	26	$7.59	$9.33	$21.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $22.39 / $45.71	Professional	TC	$18.62	$22.39	$45.71
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $15.14 / $31.62	Facility		$15.14	$15.14	$31.62
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $31.62 / $46.77	Professional		$15.14	$31.62	$46.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $69.18 / $114.82	Facility		$52.48	$69.18	$114.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.51 / $11.75 / $16.98	Facility	26	$2.51	$11.75	$16.98
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.37 / $25.12 / $36.31	Facility	TC	$5.37	$25.12	$36.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $44.67 / $114.82	Professional		$25.12	$44.67	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $14.79 / $37.15	Professional	26	$8.13	$14.79	$37.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $30.90 / $79.43	Professional	TC	$17.78	$30.90	$79.43
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $30.20 / $81.28	Facility		$19.50	$30.20	$81.28
Emblem Health Facility/Professional Facility Modifier TC Low / Median / High Price $17.38 / $17.38 / $17.38	Facility	TC	$17.38	$17.38	$17.38
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $44.67 / $69.18	Professional		$33.88	$44.67	$69.18
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $14.79 / $26.30	Professional	26	$10.23	$14.79	$26.30
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $33.11 / $47.86	Professional	TC	$25.12	$33.11	$47.86
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $15.14 / $15.14	Facility		$15.14	$15.14	$15.14
Excellus BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $9.12 / $9.12 / $9.12	Facility	TC	$9.12	$9.12	$9.12
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $43.65 / $79.43	Professional		$26.30	$43.65	$79.43
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $13.80 / $24.55	Professional	26	$9.12	$13.80	$24.55
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $30.20 / $53.70	Professional	TC	$16.60	$30.20	$53.70
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $8.71 / $11.75	Professional	26	$7.76	$8.71	$11.75
Fidelis Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $21.38 / $21.38	Professional	TC	$21.38	$21.38	$21.38
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $112.20 / $316.23	Facility		$25.12	$112.20	$316.23
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $22.91 / $64.57 / $316.23	Facility	TC	$22.91	$64.57	$316.23
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $32.36 / $48.98	Professional		$31.62	$32.36	$48.98
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $11.22 / $25.12	Professional	26	$10.96	$11.22	$25.12
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $54.95 / $56.23	Professional	TC	$54.95	$54.95	$56.23
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $46.77 / $53,703.18	Facility		$23.44	$46.77	$53,703.18
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $44.67 / $89.13	Professional		$37.15	$44.67	$89.13
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $14.79 / $27.54	Professional	26	$12.30	$14.79	$27.54
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $29.51 / $60.26	Professional	TC	$25.12	$29.51	$60.26
United Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $199.53 / $251.19	Facility		$138.04	$199.53	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $32.36 / $66.07	Professional		$25.70	$32.36	$66.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.96 / $21.88	Professional	26	$8.13	$10.96	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $21.88 / $45.71	Professional	TC	$16.98	$21.88	$45.71
Univera Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $18.62 / $38.90	Facility		$15.14	$18.62	$38.90
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $12.30 / $16.60	Facility	26	$8.51	$12.30	$16.60
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $9.12 / $11.75 / $26.92	Facility	TC	$9.12	$11.75	$26.92
Univera Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $41.69 / $79.43	Professional		$26.30	$41.69	$79.43
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $13.80 / $26.30	Professional	26	$8.71	$13.80	$26.30
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $28.84 / $53.70	Professional	TC	$16.60	$28.84	$53.70