Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.48 / $104.02 / $479.43	Facility		$29.48	$104.02	$479.43
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.39 / $9.91 / $21.87	Facility	26	$6.39	$9.91	$21.87
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.57 / $72.59 / $334.38	Facility	TC	$17.57	$72.59	$334.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.53 / $34.21 / $87.50	Professional		$21.53	$34.21	$87.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.39 / $9.10 / $33.29	Professional	26	$6.39	$9.10	$33.29
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $32.11 / $78.12 / $138.29	Professional	50	$32.11	$78.12	$138.29
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.22 / $16.17 / $29.70	Professional	52	$11.22	$16.17	$29.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.04 / $23.23 / $48.73	Professional	TC	$16.04	$23.23	$48.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.95 / $23.18 / $29.89	Professional		$21.95	$23.18	$29.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.60 / $6.95 / $9.14	Professional	26	$5.60	$6.95	$9.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.65 / $33.06 / $83.05	Professional		$25.65	$33.06	$83.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.93 / $7.49 / $19.62	Professional	26	$5.93	$7.49	$19.62
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $37.93 / $49.59 / $114.46	Professional	50	$37.93	$49.59	$114.46
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.55 / $24.80 / $55.72	Professional	TC	$19.55	$24.80	$55.72
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $11.72 / $11.72 / $35.71	Facility		$11.72	$11.72	$35.71
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $11.72 / $35.71 / $47.42	Professional		$11.72	$35.71	$47.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.63 / $85.37 / $184.53	Facility		$52.63	$85.37	$184.53
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 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 $25.67 / $46.26 / $116.36	Professional		$25.67	$46.26	$116.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.29 / $11.42 / $24.94	Professional	26	$6.29	$11.42	$24.94
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $41.47 / $41.47 / $47.09	Professional	50	$41.47	$41.47	$47.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.13 / $34.18 / $94.25	Professional	TC	$19.13	$34.18	$94.25
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 $31.13 / $39.78 / $68.48	Professional		$31.13	$39.78	$68.48
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 $26.22 / $34.18 / $55.12	Professional	TC	$26.22	$34.18	$55.12
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $10.10 / $10.10 / $10.10	Facility		$10.10	$10.10	$10.10
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 $21.03 / $39.79 / $71.33	Professional		$21.03	$39.79	$71.33
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.98 / $10.59 / $17.16	Professional	26	$4.98	$10.59	$17.16
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.05 / $30.23 / $54.17	Professional	TC	$16.05	$30.23	$54.17
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $37.02 / $37.02 / $37.02	Professional		$37.02	$37.02	$37.02
Fidelis Facility/Professional Professional Modifier 50 Low / Median / High Price $70.14 / $70.14 / $70.14	Professional	50	$70.14	$70.14	$70.14
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.06 / $99.49 / $187.80	Facility		$31.06	$99.49	$187.80
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $24.15 / $67.56 / $251.87	Facility	TC	$24.15	$67.56	$251.87
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.95 / $43.59 / $81.34	Professional		$32.95	$43.59	$81.34
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $9.53 / $18.88	Professional	26	$7.56	$9.53	$18.88
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $65.90 / $65.90 / $65.90	Professional	50	$65.90	$65.90	$65.90
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.58 / $41.58 / $41.58	Professional	TC	$41.58	$41.58	$41.58
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $39.00 / $85.39 / $252.23	Facility		$39.00	$85.39	$252.23
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 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 $27.68 / $46.58 / $104.88	Professional		$27.68	$46.58	$104.88
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $6.59 / $11.02 / $24.23	Professional	26	$6.59	$11.02	$24.23
MVP Health Care Facility/Professional Professional Modifier 50 Low / Median / High Price $41.47 / $41.47 / $47.09	Professional	50	$41.47	$41.47	$47.09
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $19.73 / $31.74 / $82.22	Professional	TC	$19.73	$31.74	$82.22
United Facility/Professional Professional Modifier Low / Median / High Price $25.92 / $33.20 / $69.70	Professional		$25.92	$33.20	$69.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.64 / $8.66 / $19.16	Professional	26	$6.64	$8.66	$19.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.84 / $25.59 / $51.97	Professional	TC	$19.84	$25.59	$51.97
Univera Facility/Professional Facility Modifier Low / Median / High Price $39.14 / $39.14 / $81.59	Facility		$39.14	$39.14	$81.59
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 Facility Modifier TC Low / Median / High Price $29.73 / $29.73 / $60.59	Facility	TC	$29.73	$29.73	$60.59
Univera Facility/Professional Professional Modifier Low / Median / High Price $21.03 / $49.45 / $85.96	Professional		$21.03	$49.45	$85.96
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $4.98 / $12.01 / $21.56	Professional	26	$4.98	$12.01	$21.56
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $16.05 / $37.44 / $67.17	Professional	TC	$16.05	$37.44	$67.17