Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.19 / $18.29 / $33.28	Facility	26	$12.19	$18.29	$33.28
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.77 / $49.84 / $185.12	Facility	TC	$23.77	$49.84	$185.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.69 / $44.12 / $99.33	Professional		$32.69	$44.12	$99.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.19 / $15.25 / $32.15	Professional	26	$12.19	$15.25	$32.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.50 / $28.01 / $55.26	Professional	TC	$20.50	$28.01	$55.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.22 / $35.79 / $45.95	Professional		$34.22	$35.79	$45.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.67 / $45.23 / $111.04	Professional		$35.67	$45.23	$111.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $13.97 / $34.31	Professional	26	$10.68	$13.97	$34.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.98 / $31.02 / $65.01	Professional	TC	$24.98	$31.02	$65.01
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $22.08 / $41.91 / $64.00	Professional		$22.08	$41.91	$64.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $16.60 / $16.60	Facility	26	$16.60	$16.60	$16.60
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 $34.43 / $60.70 / $138.57	Professional		$34.43	$60.70	$138.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.26 / $20.62 / $44.26	Professional	26	$11.26	$20.62	$44.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.35 / $40.29 / $94.41	Professional	TC	$23.35	$40.29	$94.41
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $42.43 / $56.25 / $93.35	Professional		$42.43	$56.25	$93.35
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.95 / $18.98 / $30.69	Professional	26	$13.95	$18.98	$30.69
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.65 / $41.30 / $66.48	Professional	TC	$31.65	$41.30	$66.48
Excellus BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $12.12 / $12.12 / $12.12	Facility	TC	$12.12	$12.12	$12.12
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.79 / $53.72 / $96.27	Professional		$35.79	$53.72	$96.27
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.87 / $19.53 / $30.95	Professional	26	$12.87	$19.53	$30.95
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.00 / $36.45 / $65.31	Professional	TC	$22.00	$36.45	$65.31
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $35.15 / $35.15 / $45.88	Professional		$35.15	$35.15	$45.88
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $27.84 / $29.94 / $100.95	Facility	TC	$27.84	$29.94	$100.95
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.42 / $44.18 / $63.12	Professional		$43.42	$44.18	$63.12
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.57 / $16.57 / $31.42	Professional	26	$16.57	$16.57	$31.42
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $16.60 / $16.60	Facility	26	$16.60	$16.60	$16.60
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 $36.57 / $60.04 / $128.29	Professional		$36.57	$60.04	$128.29
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $11.79 / $20.73 / $44.26	Professional	26	$11.79	$20.73	$44.26
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $24.05 / $38.70 / $84.03	Professional	TC	$24.05	$38.70	$84.03
United Facility/Professional Professional Modifier Low / Median / High Price $36.38 / $45.47 / $115.42	Professional		$36.38	$45.47	$115.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.48 / $16.53 / $36.15	Professional	26	$12.48	$16.53	$36.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.61 / $29.74 / $70.75	Professional	TC	$23.61	$29.74	$70.75
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $16.98 / $25.17	Facility	26	$16.98	$16.98	$25.17
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $35.84 / $35.84 / $38.50	Facility	TC	$35.84	$35.84	$38.50
Univera Facility/Professional Professional Modifier Low / Median / High Price $35.79 / $67.39 / $116.02	Professional		$35.79	$67.39	$116.02
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $13.67 / $22.16 / $37.29	Professional	26	$13.67	$22.16	$37.29
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $22.12 / $45.24 / $78.72	Professional	TC	$22.12	$45.24	$78.72