Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.10 / $118.46 / $750.86	Facility		$28.10	$118.46	$750.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.63 / $9.48 / $19.21	Facility	26	$6.63	$9.48	$19.21
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.48 / $74.20 / $321.57	Facility	TC	$19.48	$74.20	$321.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.71 / $30.46 / $67.19	Professional		$21.71	$30.46	$67.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.63 / $9.08 / $22.22	Professional	26	$6.63	$9.08	$22.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.58 / $19.48 / $45.70	Professional	TC	$15.58	$19.48	$45.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.35 / $21.13 / $22.10	Professional		$18.35	$21.13	$22.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.16 / $7.94 / $17.75	Professional	26	$6.16	$7.94	$17.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.04 / $27.12 / $73.78	Professional		$21.04	$27.12	$73.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.93 / $7.76 / $19.97	Professional	26	$5.93	$7.76	$19.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.81 / $19.36 / $49.31	Professional	TC	$14.81	$19.36	$49.31
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $12.22 / $12.22 / $26.64	Facility		$12.22	$12.22	$26.64
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $12.22 / $26.64 / $38.85	Professional		$12.22	$26.64	$38.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.84 / $63.96 / $187.09	Facility		$39.84	$63.96	$187.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $22.00 / $22.00 / $22.00	Facility	TC	$22.00	$22.00	$22.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.53 / $40.53 / $101.22	Professional		$22.53	$40.53	$101.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.50 / $11.78 / $25.59	Professional	26	$6.50	$11.78	$25.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.47 / $28.94 / $72.14	Professional	TC	$15.47	$28.94	$72.14
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $16.71 / $30.07 / $332.00	Facility		$16.71	$30.07	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $26.65 / $34.38 / $57.05	Professional		$26.65	$34.38	$57.05
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.88 / $10.94 / $17.34	Professional	26	$7.88	$10.94	$17.34
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.10 / $26.16 / $42.32	Professional	TC	$20.10	$26.16	$42.32
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $12.63 / $12.63 / $12.63	Facility		$12.63	$12.63	$12.63
Excellus BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $7.58 / $7.58 / $7.58	Facility	TC	$7.58	$7.58	$7.58
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.47 / $32.82 / $58.83	Professional		$18.47	$32.82	$58.83
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.16 / $11.04 / $17.89	Professional	26	$5.16	$11.04	$17.89
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.30 / $22.84 / $40.94	Professional	TC	$13.30	$22.84	$40.94
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $28.30 / $28.74 / $30.70	Professional		$28.30	$28.74	$30.70
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $6.24 / $8.13 / $8.13	Professional	26	$6.24	$8.13	$8.13
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $86.65 / $188.10 / $415.50	Facility		$86.65	$188.10	$415.50
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $24.33 / $53.05 / $333.48	Facility	TC	$24.33	$53.05	$333.48
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.53 / $33.76 / $51.54	Professional		$28.53	$33.76	$51.54
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.92 / $9.96 / $20.38	Professional	26	$8.92	$9.96	$20.38
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.70 / $35.70 / $35.70	Professional	TC	$35.70	$35.70	$35.70
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $34.00 / $64.08 / $254.50	Facility		$34.00	$64.08	$254.50
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
MVP Health Care Facility/Professional Facility Modifier TC Low / Median / High Price $22.00 / $22.00 / $22.00	Facility	TC	$22.00	$22.00	$22.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $24.87 / $40.15 / $94.32	Professional		$24.87	$40.15	$94.32
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $6.83 / $11.46 / $25.13	Professional	26	$6.83	$11.46	$25.13
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $15.84 / $26.06 / $64.40	Professional	TC	$15.84	$26.06	$64.40
United Facility/Professional Professional Modifier Low / Median / High Price $23.13 / $30.09 / $62.55	Professional		$23.13	$30.09	$62.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.78 / $9.02 / $19.32	Professional	26	$6.78	$9.02	$19.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.52 / $20.76 / $43.91	Professional	TC	$16.52	$20.76	$43.91
Univera Facility/Professional Facility Modifier Low / Median / High Price $32.28 / $32.28 / $87.78	Facility		$32.28	$32.28	$87.78
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $9.82 / $9.82 / $37.14	Facility	26	$9.82	$9.82	$37.14
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $22.46 / $22.46 / $74.84	Facility	TC	$22.46	$22.46	$74.84
Univera Facility/Professional Professional Modifier Low / Median / High Price $18.47 / $41.18 / $74.02	Professional		$18.47	$41.18	$74.02
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $5.16 / $12.52 / $22.48	Professional	26	$5.16	$12.52	$22.48
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $13.30 / $28.66 / $51.54	Professional	TC	$13.30	$28.66	$51.54