Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.34 / $64.18 / $582.46	Facility		$25.34	$64.18	$582.46
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.64 / $10.34 / $22.76	Facility	26	$6.64	$10.34	$22.76
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.07 / $67.91 / $213.13	Facility	TC	$19.07	$67.91	$213.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.85 / $32.83 / $86.70	Professional		$21.85	$32.83	$86.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.63 / $8.63 / $19.91	Professional	26	$6.63	$8.63	$19.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.19 / $21.80 / $47.28	Professional	TC	$15.19	$21.80	$47.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.33 / $21.33 / $25.72	Professional		$21.33	$21.33	$25.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.09 / $7.51 / $11.91	Professional	26	$6.09	$7.51	$11.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.30 / $31.70 / $76.34	Professional		$24.30	$31.70	$76.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.93 / $7.76 / $18.88	Professional	26	$5.93	$7.76	$18.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.30 / $23.22 / $51.12	Professional	TC	$18.30	$23.22	$51.12
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $12.22 / $12.22 / $32.84	Facility		$12.22	$12.22	$32.84
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $12.22 / $32.84 / $45.06	Professional		$12.22	$32.84	$45.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $49.27 / $78.61 / $201.26	Facility		$49.27	$78.61	$201.26
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 $27.22 / $27.22 / $27.22	Facility	TC	$27.22	$27.22	$27.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $44.55 / $105.73	Professional		$25.20	$44.55	$105.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.16 / $11.63 / $25.59	Professional	26	$6.16	$11.63	$25.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.44 / $32.61 / $86.85	Professional	TC	$18.44	$32.61	$86.85
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $20.66 / $37.14 / $332.00	Facility		$20.66	$37.14	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $30.22 / $38.61 / $66.48	Professional		$30.22	$38.61	$66.48
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 $24.86 / $32.39 / $52.28	Professional	TC	$24.86	$32.39	$52.28
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 $19.92 / $38.27 / $68.58	Professional		$19.92	$38.27	$68.58
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.63 / $11.04 / $17.89	Professional	26	$4.63	$11.04	$17.89
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.29 / $28.28 / $50.69	Professional	TC	$15.29	$28.28	$50.69
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $33.61 / $35.47 / $35.86	Professional		$33.61	$35.47	$35.86
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.59 / $149.82 / $267.57	Facility		$35.59	$149.82	$267.57
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $23.47 / $60.01 / $341.10	Facility	TC	$23.47	$60.01	$341.10
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.46 / $42.31 / $78.22	Professional		$31.46	$42.31	$78.22
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.84 / $12.46 / $20.02	Professional	26	$9.84	$12.46	$20.02
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $41.00 / $78.65 / $237.48	Facility		$41.00	$78.65	$237.48
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 $27.22 / $27.22 / $27.22	Facility	TC	$27.22	$27.22	$27.22
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $27.14 / $43.84 / $99.44	Professional		$27.14	$43.84	$99.44
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $6.50 / $11.46 / $25.13	Professional	26	$6.50	$11.46	$25.13
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $18.59 / $29.83 / $76.97	Professional	TC	$18.59	$29.83	$76.97
United Facility/Professional Professional Modifier Low / Median / High Price $26.44 / $32.45 / $67.76	Professional		$26.44	$32.45	$67.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.02 / $9.02 / $19.62	Professional	26	$7.02	$9.02	$19.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.91 / $23.75 / $54.34	Professional	TC	$18.91	$23.75	$54.34
Univera Facility/Professional Facility Modifier Low / Median / High Price $37.63 / $37.63 / $94.43	Facility		$37.63	$37.63	$94.43
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $9.82 / $9.82 / $27.97	Facility	26	$9.82	$9.82	$27.97
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $27.82 / $27.82 / $68.15	Facility	TC	$27.82	$27.82	$68.15
Univera Facility/Professional Professional Modifier Low / Median / High Price $19.92 / $48.01 / $85.04	Professional		$19.92	$48.01	$85.04
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $4.63 / $12.52 / $22.48	Professional	26	$4.63	$12.52	$22.48
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $15.29 / $35.47 / $63.81	Professional	TC	$15.29	$35.47	$63.81