Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.75 / $91.40 / $476.86	Facility		$29.75	$91.40	$476.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $11.67 / $22.79	Facility	26	$8.46	$11.67	$22.79
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.90 / $72.61 / $284.79	Facility	TC	$22.90	$72.61	$284.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.17 / $36.61 / $86.07	Professional		$26.17	$36.61	$86.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $11.22 / $30.12	Professional	26	$8.46	$11.22	$30.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.71 / $23.80 / $47.87	Professional	TC	$17.71	$23.80	$47.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.58 / $25.98 / $33.24	Professional		$21.58	$25.98	$33.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.09 / $9.21 / $13.82	Professional	26	$7.09	$9.21	$13.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.89 / $31.89 / $82.48	Professional		$24.89	$31.89	$82.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $8.93 / $23.75	Professional	26	$6.92	$8.93	$23.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.55 / $22.96 / $55.21	Professional	TC	$17.55	$22.96	$55.21
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $14.19 / $14.19 / $31.41	Facility		$14.19	$14.19	$31.41
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $14.19 / $31.41 / $45.60	Professional		$14.19	$31.41	$45.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.25 / $75.23 / $241.04	Facility		$47.25	$75.23	$241.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.16 / $11.16 / $11.16	Facility	26	$11.16	$11.16	$11.16
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 $26.39 / $48.02 / $117.07	Professional		$26.39	$48.02	$117.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.57 / $14.03 / $32.35	Professional	26	$7.57	$14.03	$32.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.19 / $34.36 / $83.11	Professional	TC	$18.19	$34.36	$83.11
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 $33.36 / $42.70 / $67.28	Professional		$33.36	$42.70	$67.28
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.16 / $12.63 / $20.14	Professional	26	$9.16	$12.63	$20.14
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 $23.10 / $38.72 / $69.39	Professional		$23.10	$38.72	$69.39
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.12 / $12.83 / $20.79	Professional	26	$6.12	$12.83	$20.79
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $27.12 / $48.60	Professional	TC	$16.98	$27.12	$48.60
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $33.29 / $35.15 / $61.48	Professional		$33.29	$35.15	$61.48
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $8.25 / $8.25 / $8.25	Professional	26	$8.25	$8.25	$8.25
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.63 / $137.33 / $255.09	Facility		$25.63	$137.33	$255.09
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $25.10 / $63.95 / $426.50	Facility	TC	$25.10	$63.95	$426.50
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.64 / $43.42 / $79.13	Professional		$33.64	$43.42	$79.13
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.36 / $12.65 / $21.78	Professional	26	$10.36	$12.65	$21.78
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $41.10 / $75.29 / $256.04	Facility		$41.10	$75.29	$256.04
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $11.16 / $11.16 / $11.16	Facility	26	$11.16	$11.16	$11.16
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 $29.15 / $47.55 / $104.32	Professional		$29.15	$47.55	$104.32
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $13.70 / $28.91	Professional	26	$8.02	$13.70	$28.91
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $18.36 / $28.99 / $73.70	Professional	TC	$18.36	$28.99	$73.70
United Facility/Professional Professional Modifier Low / Median / High Price $26.86 / $33.64 / $72.53	Professional		$26.86	$33.64	$72.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.17 / $10.47 / $24.91	Professional	26	$8.17	$10.47	$24.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.46 / $23.97 / $52.93	Professional	TC	$18.46	$23.97	$52.93
Univera Facility/Professional Facility Modifier Low / Median / High Price $38.08 / $38.08 / $110.45	Facility		$38.08	$38.08	$110.45
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $11.41 / $11.41 / $35.18	Facility	26	$11.41	$11.41	$35.18
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $26.67 / $26.67 / $76.42	Facility	TC	$26.67	$26.67	$76.42
Univera Facility/Professional Professional Modifier Low / Median / High Price $23.10 / $48.58 / $87.30	Professional		$23.10	$48.58	$87.30
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $6.12 / $14.55 / $26.12	Professional	26	$6.12	$14.55	$26.12
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $34.02 / $61.18	Professional	TC	$16.98	$34.02	$61.18