Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.56 / $78.87 / $352.56	Facility		$23.56	$78.87	$352.56
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.38 / $8.36 / $14.51	Facility	26	$6.38	$8.36	$14.51
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.51 / $63.29 / $341.84	Facility	TC	$16.51	$63.29	$341.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.14 / $31.10 / $81.56	Professional		$17.14	$31.10	$81.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.38 / $8.32 / $32.50	Professional	26	$6.38	$8.32	$32.50
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.14 / $60.41 / $124.60	Professional	50	$17.14	$60.41	$124.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.10 / $14.57 / $28.10	Professional	52	$10.10	$14.57	$28.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.81 / $21.68 / $55.82	Professional	TC	$13.81	$21.68	$55.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.46 / $21.60 / $24.68	Professional		$20.46	$21.60	$24.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $1.91 / $5.99 / $8.56	Professional	26	$1.91	$5.99	$8.56
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $32.39 / $32.39 / $37.03	Professional	50	$32.39	$32.39	$37.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.28 / $30.44 / $73.58	Professional		$23.28	$30.44	$73.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.72 / $7.49 / $18.18	Professional	26	$5.72	$7.49	$18.18
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $34.92 / $44.31 / $100.72	Professional	50	$34.92	$44.31	$100.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.55 / $21.80 / $48.90	Professional	TC	$17.55	$21.80	$48.90
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $11.72 / $11.72 / $31.89	Facility		$11.72	$11.72	$31.89
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $11.72 / $31.89 / $43.60	Professional		$11.72	$31.89	$43.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.25 / $76.36 / $176.85	Facility		$47.25	$76.36	$176.85
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 $26.47 / $26.47 / $26.47	Facility	TC	$26.47	$26.47	$26.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.64 / $42.49 / $101.66	Professional		$23.64	$42.49	$101.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.91 / $11.06 / $24.61	Professional	26	$5.91	$11.06	$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 $17.13 / $31.51 / $84.36	Professional	TC	$17.13	$31.51	$84.36
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $19.80 / $35.61 / $332.00	Facility		$19.80	$35.61	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $28.98 / $37.01 / $63.76	Professional		$28.98	$37.01	$63.76
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 $23.85 / $31.06 / $50.14	Professional	TC	$23.85	$31.06	$50.14
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 $18.76 / $37.08 / $66.45	Professional		$18.76	$37.08	$66.45
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 $14.32 / $27.51 / $49.30	Professional	TC	$14.32	$27.51	$49.30
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $34.44 / $34.44 / $34.44	Professional		$34.44	$34.44	$34.44
Fidelis Facility/Professional Professional Modifier 50 Low / Median / High Price $57.96 / $65.26 / $65.26	Professional	50	$57.96	$65.26	$65.26
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $24.74 / $110.85 / $215.67	Facility		$24.74	$110.85	$215.67
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $20.79 / $53.87 / $409.46	Facility	TC	$20.79	$53.87	$409.46
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.44 / $33.38 / $42.36	Professional		$30.44	$33.38	$42.36
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $9.55 / $18.89	Professional	26	$8.56	$9.55	$18.89
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $60.88 / $60.88 / $99.22	Professional	50	$60.88	$60.88	$99.22
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $36.00 / $76.41 / $254.50	Facility		$36.00	$76.41	$254.50
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 $26.47 / $26.47 / $26.47	Facility	TC	$26.47	$26.47	$26.47
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $23.64 / $41.38 / $96.42	Professional		$23.64	$41.38	$96.42
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $6.25 / $11.02 / $24.23	Professional	26	$6.25	$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 $17.73 / $28.52 / $73.81	Professional	TC	$17.73	$28.52	$73.81
United Facility/Professional Professional Modifier Low / Median / High Price $24.22 / $30.68 / $61.90	Professional		$24.22	$30.68	$61.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.64 / $8.69 / $20.63	Professional	26	$6.64	$8.69	$20.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.03 / $22.95 / $51.34	Professional	TC	$18.03	$22.95	$51.34
Univera Facility/Professional Facility Modifier Low / Median / High Price $36.47 / $36.47 / $81.59	Facility		$36.47	$36.47	$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 $27.05 / $27.05 / $59.40	Facility	TC	$27.05	$27.05	$59.40
Univera Facility/Professional Professional Modifier Low / Median / High Price $18.76 / $46.03 / $82.40	Professional		$18.76	$46.03	$82.40
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 $14.32 / $34.02 / $61.13	Professional	TC	$14.32	$34.02	$61.13