Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.82 / $142.82 / $506.86	Facility		$32.82	$142.82	$506.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.63 / $9.76 / $19.21	Facility	26	$6.63	$9.76	$19.21
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.11 / $90.28 / $304.81	Facility	TC	$22.11	$90.28	$304.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.93 / $36.10 / $122.10	Professional		$16.93	$36.10	$122.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.84 / $11.11 / $33.86	Professional	26	$6.84	$11.11	$33.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $34.57 / $79.14 / $130.54	Professional	50	$34.57	$79.14	$130.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.44 / $26.62 / $64.40	Professional	TC	$17.44	$26.62	$64.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.33 / $24.37 / $28.97	Professional		$21.33	$24.37	$28.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.09 / $7.23 / $11.21	Professional	26	$6.09	$7.23	$11.21
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $33.76 / $33.76 / $33.76	Professional	50	$33.76	$33.76	$33.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.59 / $31.70 / $82.52	Professional		$24.59	$31.70	$82.52
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 50 Low / Median / High Price $36.36 / $47.55 / $118.53	Professional	50	$36.36	$47.55	$118.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.30 / $23.94 / $58.10	Professional	TC	$18.30	$23.94	$58.10
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 $50.00 / $78.61 / $204.70	Facility		$50.00	$78.61	$204.70
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 $27.59 / $27.59 / $27.59	Facility	TC	$27.59	$27.59	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.32 / $48.99 / $119.06	Professional		$26.32	$48.99	$119.06
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 50 Low / Median / High Price $38.75 / $38.75 / $43.94	Professional	50	$38.75	$38.75	$43.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.88 / $36.33 / $86.85	Professional	TC	$18.88	$36.33	$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 / $40.79 / $66.48	Professional		$30.22	$40.79	$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 $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 $23.16 / $38.65 / $69.28	Professional		$23.16	$38.65	$69.28
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 $18.54 / $28.67 / $51.39	Professional	TC	$18.54	$28.67	$51.39
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $35.47 / $35.86 / $60.97	Professional		$35.47	$35.86	$60.97
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $6.24 / $8.13 / $10.11	Professional	26	$6.24	$8.13	$10.11
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.53 / $90.70 / $367.25	Facility		$28.53	$90.70	$367.25
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $25.02 / $71.79 / $343.57	Facility	TC	$25.02	$71.79	$343.57
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.89 / $42.31 / $59.38	Professional		$32.89	$42.31	$59.38
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.84 / $9.97 / $20.38	Professional	26	$9.84	$9.97	$20.38
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $65.78 / $84.60 / $120.50	Professional	50	$65.78	$84.60	$120.50
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.12 / $45.12 / $45.12	Professional	TC	$45.12	$45.12	$45.12
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $42.85 / $78.65 / $254.50	Facility		$42.85	$78.65	$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 $27.59 / $27.59 / $27.59	Facility	TC	$27.59	$27.59	$27.59
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $28.45 / $47.31 / $104.19	Professional		$28.45	$47.31	$104.19
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $6.62 / $11.46 / $25.13	Professional	26	$6.62	$11.46	$25.13
MVP Health Care Facility/Professional Professional Modifier 50 Low / Median / High Price $38.75 / $38.75 / $43.94	Professional	50	$38.75	$38.75	$43.94
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $19.41 / $30.01 / $76.97	Professional	TC	$19.41	$30.01	$76.97
United Facility/Professional Professional Modifier Low / Median / High Price $26.69 / $32.22 / $66.98	Professional		$26.69	$32.22	$66.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.79 / $8.77 / $19.14	Professional	26	$6.79	$8.77	$19.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.07 / $24.21 / $52.66	Professional	TC	$19.07	$24.21	$52.66
Univera Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $94.43	Facility		$38.02	$38.02	$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 $28.20 / $28.20 / $74.09	Facility	TC	$28.20	$28.20	$74.09
Univera Facility/Professional Professional Modifier Low / Median / High Price $23.16 / $48.01 / $85.90	Professional		$23.16	$48.01	$85.90
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 $18.54 / $35.47 / $63.81	Professional	TC	$18.54	$35.47	$63.81