Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $81.28 / $758.58	Facility		$28.18	$81.28	$758.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.61 / $9.33 / $22.91	Facility	26	$6.61	$9.33	$22.91
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.50 / $69.18 / $354.81	Facility	TC	$19.50	$69.18	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $38.90 / $112.20	Professional		$22.91	$38.90	$112.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.96 / $33.11	Professional	26	$7.08	$10.96	$33.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $22.91 / $56.23	Professional	TC	$15.14	$22.91	$56.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $25.70 / $29.51	Professional		$19.50	$25.70	$29.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.68 / $10.47 / $19.05	Professional	26	$4.68	$10.47	$19.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $26.30 / $66.07	Professional		$20.89	$26.30	$66.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $7.76 / $17.38	Professional	26	$6.03	$7.76	$17.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $18.20 / $44.67	Professional	TC	$14.79	$18.20	$44.67
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $12.30 / $26.92	Facility		$12.30	$12.30	$26.92
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $26.92 / $38.90	Professional		$12.30	$26.92	$38.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $64.57 / $190.55	Facility		$43.65	$64.57	$190.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $4.57 / $21.38 / $30.20	Facility	TC	$4.57	$21.38	$30.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $39.81 / $114.82	Professional		$23.99	$39.81	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $12.30 / $30.90	Professional	26	$6.76	$12.30	$30.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $28.84 / $91.20	Professional	TC	$15.85	$28.84	$91.20
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $26.30 / $70.79	Facility		$16.98	$26.30	$70.79
Emblem Health Facility/Professional Facility Modifier TC Low / Median / High Price $17.38 / $17.38 / $17.38	Facility	TC	$17.38	$17.38	$17.38
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $38.02 / $57.54	Professional		$28.84	$38.02	$57.54
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $12.30 / $25.70	Professional	26	$8.51	$12.30	$25.70
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $28.18 / $40.74	Professional	TC	$21.38	$28.18	$40.74
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $12.59 / $12.59	Facility		$12.59	$12.59	$12.59
Excellus BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $7.59 / $7.59 / $7.59	Facility	TC	$7.59	$7.59	$7.59
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $36.31 / $66.07	Professional		$18.62	$36.31	$66.07
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.96 / $19.95	Professional	26	$6.92	$10.96	$19.95
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $25.12 / $45.71	Professional	TC	$13.18	$25.12	$45.71
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $147.91 / $389.05	Facility		$48.98	$147.91	$389.05
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $25.12 / $64.57 / $331.13	Facility	TC	$25.12	$64.57	$331.13
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $33.88 / $51.29	Professional		$28.18	$33.88	$51.29
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $10.00 / $17.78	Professional	26	$9.77	$10.00	$17.78
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $36.31 / $36.31	Professional	TC	$36.31	$36.31	$36.31
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $38.90 / $53,703.18	Facility		$19.50	$38.90	$53,703.18
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $38.90 / $72.44	Professional		$33.11	$38.90	$72.44
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.30 / $22.39	Professional	26	$10.00	$12.30	$22.39
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $26.30 / $51.29	Professional	TC	$22.39	$26.30	$51.29
United Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $239.88 / $302.00	Facility		$165.96	$239.88	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $28.84 / $57.54	Professional		$21.88	$28.84	$57.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $8.71 / $17.78	Professional	26	$6.61	$8.71	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $19.95 / $40.74	Professional	TC	$15.49	$19.95	$40.74
Univera Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $20.89 / $69.18	Facility		$12.59	$20.89	$69.18
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $6.92 / $9.77 / $43.65	Facility	26	$6.92	$9.77	$43.65
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $7.59 / $14.45 / $60.26	Facility	TC	$7.59	$14.45	$60.26
Univera Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $36.31 / $70.79	Professional		$18.62	$36.31	$70.79
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.96 / $24.55	Professional	26	$6.92	$10.96	$24.55
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $25.12 / $52.48	Professional	TC	$13.18	$25.12	$52.48