Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.79 / $126.18 / $380.19	Facility		$34.79	$126.18	$380.19
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $12.38 / $25.16	Facility	26	$8.46	$12.38	$25.16
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.26 / $110.58 / $342.53	Facility	TC	$29.26	$110.58	$342.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.01 / $45.69 / $107.92	Professional		$27.01	$45.69	$107.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $12.49 / $35.70	Professional	26	$8.46	$12.49	$35.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.55 / $29.71 / $74.08	Professional	TC	$18.55	$29.71	$74.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.87 / $35.17 / $40.10	Professional		$25.87	$35.17	$40.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.86 / $8.26 / $17.57	Professional	26	$7.86	$8.26	$17.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.17 / $38.65 / $99.65	Professional		$30.17	$38.65	$99.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.62 / $9.82 / $25.46	Professional	26	$7.62	$9.82	$25.46
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.06 / $27.97 / $62.90	Professional	TC	$22.06	$27.97	$62.90
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $15.67 / $15.67 / $40.00	Facility		$15.67	$15.67	$40.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $15.67 / $40.00 / $55.68	Professional		$15.67	$40.00	$55.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.36 / $95.45 / $256.04	Facility		$59.36	$95.45	$256.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
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 $30.84 / $55.02 / $134.31	Professional		$30.84	$55.02	$134.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $15.06 / $32.61	Professional	26	$8.27	$15.06	$32.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.27 / $40.77 / $105.55	Professional	TC	$22.27	$40.77	$105.55
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $24.62 / $44.20 / $332.00	Facility		$24.62	$44.20	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $36.75 / $48.26 / $80.84	Professional		$36.75	$48.26	$80.84
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $13.91 / $24.32	Professional	26	$10.11	$13.91	$24.32
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.62 / $38.63 / $70.72	Professional	TC	$29.62	$38.63	$70.72
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 $27.68 / $46.92 / $84.09	Professional		$27.68	$46.92	$84.09
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $14.16 / $22.95	Professional	26	$6.46	$14.16	$22.95
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.26 / $34.11 / $61.14	Professional	TC	$20.26	$34.11	$61.14
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $42.26 / $42.99 / $43.41	Professional		$42.26	$42.99	$43.41
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $12.66 / $13.81	Professional	26	$7.95	$12.66	$13.81
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $40.93 / $149.11 / $317.24	Facility		$40.93	$149.11	$317.24
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $26.63 / $73.06 / $288.47	Facility	TC	$26.63	$73.06	$288.47
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.97 / $51.45 / $64.09	Professional		$38.97	$51.45	$64.09
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.44 / $14.00 / $26.14	Professional	26	$11.44	$14.00	$26.14
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.34 / $43.94 / $68.54	Professional	TC	$26.34	$43.94	$68.54
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $51.00 / $95.55 / $264.06	Facility		$51.00	$95.55	$264.06
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
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 $33.49 / $54.36 / $121.96	Professional		$33.49	$54.36	$121.96
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $8.64 / $14.62 / $31.78	Professional	26	$8.64	$14.62	$31.78
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $22.41 / $35.47 / $91.96	Professional	TC	$22.41	$35.47	$91.96
United Facility/Professional Professional Modifier Low / Median / High Price $32.26 / $40.19 / $81.27	Professional		$32.26	$40.19	$81.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.76 / $11.55 / $25.18	Professional	26	$8.76	$11.55	$25.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.78 / $27.47 / $59.73	Professional	TC	$22.78	$27.47	$59.73
Univera Facility/Professional Facility Modifier Low / Median / High Price $46.15 / $46.15 / $112.68	Facility		$46.15	$46.15	$112.68
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $12.60 / $12.60 / $35.18	Facility	26	$12.60	$12.60	$35.18
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $33.54 / $33.54 / $83.50	Facility	TC	$33.54	$33.54	$83.50
Univera Facility/Professional Professional Modifier Low / Median / High Price $27.68 / $58.38 / $104.27	Professional		$27.68	$58.38	$104.27
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $16.07 / $28.84	Professional	26	$6.46	$16.07	$28.84
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $21.22 / $42.31 / $76.95	Professional	TC	$21.22	$42.31	$76.95