Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.86 / $9.47 / $20.07	Facility	26	$5.86	$9.47	$20.07
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $13.60 / $23.04 / $96.00	Facility	TC	$13.60	$23.04	$96.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.71 / $23.58 / $45.13	Professional		$17.71	$23.58	$45.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.86 / $7.58 / $16.55	Professional	26	$5.86	$7.58	$16.55
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $45.36 / $45.36 / $45.36	Professional	50	$45.36	$45.36	$45.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.85 / $14.99 / $29.76	Professional	TC	$11.85	$14.99	$29.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $14.28 / $16.87 / $21.64	Professional		$14.28	$16.87	$21.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.12 / $7.85 / $10.50	Professional	26	$4.12	$7.85	$10.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.29 / $21.00 / $58.02	Professional		$16.29	$21.00	$58.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.26 / $6.88 / $16.80	Professional	26	$5.26	$6.88	$16.80
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $24.09 / $31.50 / $80.79	Professional	50	$24.09	$31.50	$80.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.80 / $14.12 / $36.36	Professional	TC	$10.80	$14.12	$36.36
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $10.74 / $19.47 / $30.21	Professional		$10.74	$19.47	$30.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $8.46 / $8.46	Facility	26	$8.46	$8.46	$8.46
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $16.03 / $16.03 / $16.03	Facility	TC	$16.03	$16.03	$16.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.70 / $32.49 / $77.95	Professional		$17.70	$32.49	$77.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.42 / $10.37 / $22.66	Professional	26	$5.42	$10.37	$22.66
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $31.05 / $31.05 / $35.06	Professional	50	$31.05	$31.05	$35.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.54 / $22.03 / $51.96	Professional	TC	$11.54	$22.03	$51.96
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $21.92 / $29.09 / $44.13	Professional		$21.92	$29.09	$44.13
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.93 / $9.65 / $15.25	Professional	26	$6.93	$9.65	$15.25
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.67 / $19.04 / $30.88	Professional	TC	$14.67	$19.04	$30.88
Excellus BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $6.06 / $6.06 / $6.06	Facility	TC	$6.06	$6.06	$6.06
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.98 / $25.40 / $45.52	Professional		$15.98	$25.40	$45.52
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.07 / $9.69 / $15.73	Professional	26	$4.07	$9.69	$15.73
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $16.62 / $29.79	Professional	TC	$11.48	$16.62	$29.79
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $16.96 / $29.19 / $317.60	Facility	TC	$16.96	$29.19	$317.60
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.64 / $28.33 / $29.18	Professional		$24.64	$28.33	$29.18
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.77 / $9.13 / $15.52	Professional	26	$8.77	$9.13	$15.52
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $50.08 / $50.08 / $50.08	Professional	50	$50.08	$50.08	$50.08
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $8.46 / $8.46	Facility	26	$8.46	$8.46	$8.46
MVP Health Care Facility/Professional Facility Modifier TC Low / Median / High Price $16.03 / $16.03 / $16.03	Facility	TC	$16.03	$16.03	$16.03
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $19.61 / $32.19 / $73.05	Professional		$19.61	$32.19	$73.05
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $5.94 / $10.10 / $22.27	Professional	26	$5.94	$10.10	$22.27
MVP Health Care Facility/Professional Professional Modifier 50 Low / Median / High Price $31.05 / $31.05 / $35.06	Professional	50	$31.05	$31.05	$35.06
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $11.63 / $18.79 / $46.88	Professional	TC	$11.63	$18.79	$46.88
United Facility/Professional Professional Modifier Low / Median / High Price $17.91 / $23.26 / $50.04	Professional		$17.91	$23.26	$50.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.18 / $8.02 / $17.25	Professional	26	$6.18	$8.02	$17.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.65 / $15.54 / $31.31	Professional	TC	$11.65	$15.54	$31.31
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $8.63 / $8.63 / $24.46	Facility	26	$8.63	$8.63	$24.46
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $16.35 / $16.35 / $54.73	Facility	TC	$16.35	$16.35	$54.73
Univera Facility/Professional Professional Modifier Low / Median / High Price $15.98 / $31.87 / $57.27	Professional		$15.98	$31.87	$57.27
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $4.07 / $11.01 / $19.76	Professional	26	$4.07	$11.01	$19.76
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $11.93 / $20.86 / $37.51	Professional	TC	$11.93	$20.86	$37.51