Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.60 / $16.69 / $34.27	Facility	26	$10.60	$16.69	$34.27
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.13 / $51.95 / $185.43	Facility	TC	$23.13	$51.95	$185.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.55 / $42.06 / $86.07	Professional		$30.55	$42.06	$86.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.61 / $13.17 / $26.50	Professional	26	$10.61	$13.17	$26.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.94 / $26.32 / $53.23	Professional	TC	$19.94	$26.32	$53.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.95 / $32.95 / $32.95	Professional		$32.95	$32.95	$32.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.68 / $41.43 / $103.70	Professional		$32.68	$41.43	$103.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.26 / $12.11 / $30.28	Professional	26	$9.26	$12.11	$30.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.41 / $29.07 / $62.25	Professional	TC	$23.41	$29.07	$62.25
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $19.13 / $40.47 / $59.61	Professional		$19.13	$40.47	$59.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $32.79 / $32.79 / $32.79	Facility	TC	$32.79	$32.79	$32.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.51 / $56.78 / $129.66	Professional		$31.51	$56.78	$129.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $18.25 / $39.61	Professional	26	$9.80	$18.25	$39.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.26 / $38.20 / $90.40	Professional	TC	$22.26	$38.20	$90.40
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $38.97 / $52.54 / $85.76	Professional		$38.97	$52.54	$85.76
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.35 / $16.89 / $27.17	Professional	26	$12.35	$16.89	$27.17
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.62 / $38.63 / $62.22	Professional	TC	$29.62	$38.63	$62.22
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 $33.40 / $49.75 / $89.16	Professional		$33.40	$49.75	$89.16
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.17 / $17.29 / $28.02	Professional	26	$11.17	$17.29	$28.02
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $34.11 / $61.14	Professional	TC	$21.38	$34.11	$61.14
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $43.37 / $43.37 / $43.37	Professional		$43.37	$43.37	$43.37
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $27.65 / $28.92 / $74.17	Facility	TC	$27.65	$28.92	$74.17
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.88 / $55.90 / $65.95	Professional		$42.88	$55.90	$65.95
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.40 / $14.56 / $23.18	Professional	26	$14.40	$14.56	$23.18
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
MVP Health Care Facility/Professional Facility Modifier TC Low / Median / High Price $32.79 / $32.79 / $32.79	Facility	TC	$32.79	$32.79	$32.79
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $33.86 / $55.88 / $118.50	Professional		$33.86	$55.88	$118.50
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $10.27 / $17.91 / $38.42	Professional	26	$10.27	$17.91	$38.42
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $22.52 / $36.92 / $80.92	Professional	TC	$22.52	$36.92	$80.92
United Facility/Professional Professional Modifier Low / Median / High Price $33.49 / $41.95 / $89.63	Professional		$33.49	$41.95	$89.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.02 / $14.10 / $31.59	Professional	26	$11.02	$14.10	$31.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.07 / $29.03 / $61.32	Professional	TC	$23.07	$29.03	$61.32
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $15.37 / $15.37 / $21.86	Facility	26	$15.37	$15.37	$21.86
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $33.54 / $33.54 / $37.40	Facility	TC	$33.54	$33.54	$37.40
Univera Facility/Professional Professional Modifier Low / Median / High Price $33.40 / $61.92 / $107.45	Professional		$33.40	$61.92	$107.45
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $11.90 / $19.61 / $33.77	Professional	26	$11.90	$19.61	$33.77
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $21.51 / $42.31 / $73.68	Professional	TC	$21.51	$42.31	$73.68