Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.85 / $142.82 / $551.71	Facility		$34.85	$142.82	$551.71
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.16 / $11.06 / $24.57	Facility	26	$7.16	$11.06	$24.57
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.82 / $132.97 / $337.74	Facility	TC	$26.82	$132.97	$337.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.51 / $38.96 / $112.26	Professional		$13.51	$38.96	$112.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.16 / $10.15 / $30.60	Professional	26	$7.16	$10.15	$30.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.86 / $79.23 / $139.38	Professional	50	$17.86	$79.23	$139.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.20 / $24.89 / $69.94	Professional	TC	$15.20	$24.89	$69.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.86 / $27.27 / $32.90	Professional		$23.86	$27.27	$32.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.65 / $8.13 / $14.83	Professional	26	$6.65	$8.13	$14.83
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $35.78 / $35.78 / $40.90	Professional	50	$35.78	$35.78	$40.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.61 / $33.61 / $82.71	Professional		$26.61	$33.61	$82.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.62 / $8.36 / $21.79	Professional	26	$6.62	$8.36	$21.79
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.56 / $50.41 / $114.49	Professional	50	$38.56	$50.41	$114.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.30 / $24.48 / $53.67	Professional	TC	$19.30	$24.48	$53.67
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $13.19 / $13.19 / $34.75	Facility		$13.19	$13.19	$34.75
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $13.19 / $34.75 / $47.95	Professional		$13.19	$34.75	$47.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.96 / $83.13 / $201.26	Facility		$51.96	$83.13	$201.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.11 / $46.56 / $112.57	Professional		$26.11	$46.56	$112.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $12.73 / $27.63	Professional	26	$7.01	$12.73	$27.63
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $39.20 / $39.20 / $44.46	Professional	50	$39.20	$39.20	$44.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.87 / $33.68 / $91.84	Professional	TC	$18.87	$33.68	$91.84
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $21.79 / $39.15 / $332.00	Facility		$21.79	$39.15	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $32.08 / $40.90 / $70.58	Professional		$32.08	$40.90	$70.58
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.80 / $20.63	Professional	26	$8.51	$11.80	$20.63
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.22 / $34.18 / $62.65	Professional	TC	$26.22	$34.18	$62.65
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 $21.00 / $41.01 / $73.48	Professional		$21.00	$41.01	$73.48
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.53 / $11.92 / $19.32	Professional	26	$5.53	$11.92	$19.32
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.47 / $30.23 / $54.17	Professional	TC	$15.47	$30.23	$54.17
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $35.65 / $37.64 / $64.68	Professional		$35.65	$37.64	$64.68
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $9.26 / $10.91 / $11.70	Professional	26	$9.26	$10.91	$11.70
Fidelis Facility/Professional Professional Modifier 50 Low / Median / High Price $72.08 / $72.08 / $72.08	Professional	50	$72.08	$72.08	$72.08
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.21 / $112.61 / $446.25	Facility		$28.21	$112.61	$446.25
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $22.76 / $92.66 / $324.89	Facility	TC	$22.76	$92.66	$324.89
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.50 / $45.58 / $83.02	Professional		$33.50	$45.58	$83.02
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.63 / $10.78 / $21.81	Professional	26	$9.63	$10.78	$21.81
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $67.00 / $89.82 / $110.20	Professional	50	$67.00	$89.82	$110.20
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.06 / $61.02 / $61.02	Professional	TC	$38.06	$61.02	$61.02
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $83.13 / $237.48	Facility		$40.00	$83.13	$237.48
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
MVP Health Care Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $27.91 / $46.31 / $105.63	Professional		$27.91	$46.31	$105.63
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $7.37 / $12.37 / $27.10	Professional	26	$7.37	$12.37	$27.10
MVP Health Care Facility/Professional Professional Modifier 50 Low / Median / High Price $39.20 / $39.20 / $44.46	Professional	50	$39.20	$39.20	$44.46
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $19.48 / $31.24 / $81.00	Professional	TC	$19.48	$31.24	$81.00
United Facility/Professional Professional Modifier Low / Median / High Price $27.38 / $35.06 / $67.92	Professional		$27.38	$35.06	$67.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.45 / $9.74 / $21.21	Professional	26	$7.45	$9.74	$21.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $24.83 / $50.80	Professional	TC	$19.80	$24.83	$50.80
Univera Facility/Professional Facility Modifier Low / Median / High Price $40.33 / $40.33 / $96.64	Facility		$40.33	$40.33	$96.64
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $10.60 / $10.60 / $40.02	Facility	26	$10.60	$10.60	$40.02
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $29.73 / $29.73 / $81.02	Facility	TC	$29.73	$29.73	$81.02
Univera Facility/Professional Professional Modifier Low / Median / High Price $21.00 / $50.96 / $91.13	Professional		$21.00	$50.96	$91.13
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $5.53 / $13.53 / $24.28	Professional	26	$5.53	$13.53	$24.28
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $15.47 / $37.44 / $67.31	Professional	TC	$15.47	$37.44	$67.31