Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.38 / $9.64 / $18.80	Facility	26	$6.38	$9.64	$18.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.48 / $32.47 / $89.79	Professional		$19.48	$32.47	$89.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.39 / $9.10 / $24.22	Professional	26	$6.39	$9.10	$24.22
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $32.11 / $99.72 / $132.26	Professional	50	$32.11	$99.72	$132.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.93 / $21.84 / $46.22	Professional	TC	$14.93	$21.84	$46.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.51 / $25.30 / $32.40	Professional		$22.51	$25.30	$32.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.90 / $7.61 / $9.58	Professional	26	$5.90	$7.61	$9.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.48 / $31.42 / $76.45	Professional		$24.48	$31.42	$76.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.93 / $7.49 / $18.36	Professional	26	$5.93	$7.49	$18.36
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $36.04 / $47.13 / $106.68	Professional	50	$36.04	$47.13	$106.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.30 / $23.23 / $51.50	Professional	TC	$18.30	$23.23	$51.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $11.72 / $33.32 / $45.04	Professional		$11.72	$33.32	$45.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.43 / $43.18 / $105.33	Professional		$24.43	$43.18	$105.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.92 / $11.18 / $24.61	Professional	26	$5.92	$11.18	$24.61
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $37.85 / $37.85 / $42.89	Professional	50	$37.85	$37.85	$42.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.00 / $32.97 / $88.10	Professional	TC	$18.00	$32.97	$88.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $30.21 / $38.60 / $66.45	Professional		$30.21	$38.60	$66.45
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $10.53 / $16.63	Professional	26	$7.56	$10.53	$16.63
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.20 / $32.84 / $52.98	Professional	TC	$25.20	$32.84	$52.98
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.46 / $38.25 / $68.54	Professional		$19.46	$38.25	$68.54
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.44 / $10.59 / $17.16	Professional	26	$4.44	$10.59	$17.16
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.02 / $28.67 / $51.39	Professional	TC	$15.02	$28.67	$51.39
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $35.90 / $35.90 / $35.90	Professional		$35.90	$35.90	$35.90
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.38 / $42.30 / $42.46	Professional		$31.38	$42.30	$42.46
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $9.53 / $16.93	Professional	26	$8.56	$9.53	$16.93
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.47 / $37.47 / $37.47	Professional	TC	$37.47	$37.47	$37.47
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $26.50 / $42.83 / $99.59	Professional		$26.50	$42.83	$99.59
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $6.38 / $11.02 / $24.23	Professional	26	$6.38	$11.02	$24.23
MVP Health Care Facility/Professional Professional Modifier 50 Low / Median / High Price $37.85 / $37.85 / $42.89	Professional	50	$37.85	$37.85	$42.89
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $18.59 / $29.90 / $76.97	Professional	TC	$18.59	$29.90	$76.97
United Facility/Professional Professional Modifier Low / Median / High Price $25.41 / $31.77 / $66.68	Professional		$25.41	$31.77	$66.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.64 / $8.73 / $18.82	Professional	26	$6.64	$8.73	$18.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.60 / $23.52 / $48.90	Professional	TC	$18.60	$23.52	$48.90
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $9.41 / $9.41 / $25.70	Facility	26	$9.41	$9.41	$25.70
Univera Facility/Professional Professional Modifier Low / Median / High Price $19.46 / $47.98 / $84.99	Professional		$19.46	$47.98	$84.99
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $4.44 / $12.01 / $21.56	Professional	26	$4.44	$12.01	$21.56
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $15.02 / $35.97 / $63.72	Professional	TC	$15.02	$35.97	$63.72