Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.86 / $142.82 / $508.54	Facility		$36.86	$142.82	$508.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.63 / $9.48 / $19.21	Facility	26	$6.63	$9.48	$19.21
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.23 / $115.20 / $367.80	Facility	TC	$28.23	$115.20	$367.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.82 / $40.95 / $117.44	Professional		$13.82	$40.95	$117.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.89 / $11.15 / $35.60	Professional	26	$6.89	$11.15	$35.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $18.05 / $88.90 / $142.94	Professional	50	$18.05	$88.90	$142.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.16 / $28.14 / $79.15	Professional	TC	$17.16	$28.14	$79.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.31 / $28.89 / $33.67	Professional		$24.31	$28.89	$33.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.09 / $7.94 / $17.16	Professional	26	$6.09	$7.94	$17.16
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.50 / $38.50 / $44.00	Professional	50	$38.50	$38.50	$44.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.64 / $35.61 / $87.99	Professional		$27.64	$35.61	$87.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.14 / $7.76 / $19.17	Professional	26	$6.14	$7.76	$19.17
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $40.86 / $53.43 / $120.01	Professional	50	$40.86	$53.43	$120.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.31 / $27.02 / $60.18	Professional	TC	$21.31	$27.02	$60.18
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $12.22 / $12.22 / $38.57	Facility		$12.22	$12.22	$38.57
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $12.22 / $38.57 / $50.79	Professional		$12.22	$38.57	$50.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.34 / $92.09 / $195.41	Facility		$57.34	$92.09	$195.41
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 $32.44 / $32.44 / $32.44	Facility	TC	$32.44	$32.44	$32.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.67 / $48.18 / $119.00	Professional		$27.67	$48.18	$119.00
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 $43.28 / $43.28 / $49.18	Professional	50	$43.28	$43.28	$49.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.72 / $36.84 / $101.81	Professional	TC	$20.72	$36.84	$101.81
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $24.62 / $44.20 / $332.00	Facility		$24.62	$44.20	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $33.70 / $44.10 / $75.94	Professional		$33.70	$44.10	$75.94
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 $29.62 / $38.63 / $62.22	Professional	TC	$29.62	$38.63	$62.22
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 $21.77 / $43.71 / $78.33	Professional		$21.77	$43.71	$78.33
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 $17.14 / $33.72 / $60.44	Professional	TC	$17.14	$33.72	$60.44
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $34.94 / $39.90 / $69.72	Professional		$34.94	$39.90	$69.72
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $7.06 / $8.14 / $16.23	Professional	26	$7.06	$8.14	$16.23
Fidelis Facility/Professional Professional Modifier 50 Low / Median / High Price $77.73 / $77.73 / $77.73	Professional	50	$77.73	$77.73	$77.73
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.27 / $103.71 / $314.05	Facility		$30.27	$103.71	$314.05
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $26.64 / $123.26 / $334.20	Facility	TC	$26.64	$123.26	$334.20
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.24 / $48.21 / $58.49	Professional		$35.24	$48.21	$58.49
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.84 / $11.92 / $20.38	Professional	26	$9.84	$11.92	$20.38
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $70.48 / $96.64 / $116.96	Professional	50	$70.48	$96.64	$116.96
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.39 / $25.39 / $43.35	Professional	TC	$25.39	$25.39	$43.35
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $43.00 / $92.16 / $254.50	Facility		$43.00	$92.16	$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 $32.44 / $32.44 / $32.44	Facility	TC	$32.44	$32.44	$32.44
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $29.77 / $48.02 / $112.14	Professional		$29.77	$48.02	$112.14
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $6.50 / $11.46 / $25.13	Professional	26	$6.50	$11.46	$25.13
MVP Health Care Facility/Professional Professional Modifier 50 Low / Median / High Price $43.28 / $43.28 / $49.18	Professional	50	$43.28	$43.28	$49.18
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $21.51 / $34.42 / $89.53	Professional	TC	$21.51	$34.42	$89.53
United Facility/Professional Professional Modifier Low / Median / High Price $27.18 / $36.11 / $81.77	Professional		$27.18	$36.11	$81.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.02 / $9.02 / $19.32	Professional	26	$7.02	$9.02	$19.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.08 / $27.21 / $59.13	Professional	TC	$21.08	$27.21	$59.13
Univera Facility/Professional Facility Modifier Low / Median / High Price $42.98 / $42.98 / $88.37	Facility		$42.98	$42.98	$88.37
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 $33.17 / $33.17 / $65.34	Facility	TC	$33.17	$33.17	$65.34
Univera Facility/Professional Professional Modifier Low / Median / High Price $21.77 / $54.84 / $94.40	Professional		$21.77	$54.84	$94.40
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 $17.14 / $41.54 / $74.95	Professional	TC	$17.14	$41.54	$74.95