Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.99 / $104.02 / $432.17	Facility		$33.99	$104.02	$432.17
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $13.14 / $28.98	Facility	26	$8.46	$13.14	$28.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.32 / $35.61 / $93.15	Professional		$23.32	$35.61	$93.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $11.53 / $25.08	Professional	26	$8.46	$11.53	$25.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.87 / $24.21 / $48.73	Professional	TC	$16.87	$24.21	$48.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.95 / $27.56 / $36.97	Professional		$23.95	$27.56	$36.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.86 / $12.67 / $21.89	Professional	26	$7.86	$12.67	$21.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.40 / $35.71 / $85.39	Professional		$27.40	$35.71	$85.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $9.82 / $24.10	Professional	26	$7.51	$9.82	$24.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $24.68 / $54.15	Professional	TC	$19.80	$24.68	$54.15
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $15.67 / $15.67 / $35.71	Facility		$15.67	$15.67	$35.71
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $15.67 / $35.71 / $51.38	Professional		$15.67	$35.71	$51.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.30 / $85.37 / $201.26	Facility		$53.30	$85.37	$201.26
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 Professional Modifier Low / Median / High Price $28.28 / $49.70 / $118.39	Professional		$28.28	$49.70	$118.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.89 / $14.67 / $32.35	Professional	26	$7.89	$14.67	$32.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.68 / $35.40 / $94.33	Professional	TC	$19.68	$35.40	$94.33
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $22.08 / $39.65 / $332.00	Facility		$22.08	$39.65	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $33.99 / $43.14 / $74.78	Professional		$33.99	$43.14	$74.78
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $13.91 / $22.26	Professional	26	$10.11	$13.91	$22.26
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.56 / $34.61 / $55.83	Professional	TC	$26.56	$34.61	$55.83
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 Professional Modifier Low / Median / High Price $21.93 / $43.03 / $77.13	Professional		$21.93	$43.03	$77.13
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.93 / $14.11 / $22.26	Professional	26	$5.93	$14.11	$22.26
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.01 / $30.62 / $54.87	Professional	TC	$16.01	$30.62	$54.87
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $37.59 / $37.59 / $40.09	Professional		$37.59	$37.59	$40.09
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.74 / $65.95 / $217.96	Facility		$27.74	$65.95	$217.96
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.14 / $47.59 / $88.74	Professional		$36.14	$47.59	$88.74
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.44 / $12.80 / $25.68	Professional	26	$11.44	$12.80	$25.68
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $42.00 / $85.39 / $244.38	Facility		$42.00	$85.39	$244.38
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 Professional Modifier Low / Median / High Price $30.82 / $49.55 / $112.43	Professional		$30.82	$49.55	$112.43
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $14.62 / $31.78	Professional	26	$8.27	$14.62	$31.78
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $20.11 / $32.18 / $82.44	Professional	TC	$20.11	$32.18	$82.44
United Facility/Professional Professional Modifier Low / Median / High Price $29.22 / $36.28 / $75.98	Professional		$29.22	$36.28	$75.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.76 / $11.57 / $29.54	Professional	26	$8.76	$11.57	$29.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.50 / $26.47 / $54.52	Professional	TC	$20.50	$26.47	$54.52
Univera Facility/Professional Facility Modifier Low / Median / High Price $42.32 / $42.32 / $101.58	Facility		$42.32	$42.32	$101.58
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $12.21 / $12.21 / $35.18	Facility	26	$12.21	$12.21	$35.18
Univera Facility/Professional Professional Modifier Low / Median / High Price $21.93 / $53.99 / $95.64	Professional		$21.93	$53.99	$95.64
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $5.93 / $16.07 / $28.84	Professional	26	$5.93	$16.07	$28.84
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $16.01 / $37.92 / $69.06	Professional	TC	$16.01	$37.92	$69.06