Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.36 / $7.64 / $15.32	Facility	26	$5.36	$7.64	$15.32
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.36 / $102.57 / $237.62	Facility	TC	$22.36	$102.57	$237.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.62 / $41.19 / $120.37	Professional		$23.62	$41.19	$120.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.36 / $7.95 / $24.95	Professional	26	$5.36	$7.95	$24.95
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $15.80 / $117.00 / $151.05	Professional	50	$15.80	$117.00	$151.05
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.06 / $17.48 / $31.60	Professional	52	$12.06	$17.48	$31.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.07 / $27.96 / $59.46	Professional	TC	$19.07	$27.96	$59.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.89 / $26.34 / $34.76	Professional		$24.89	$26.34	$34.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.83 / $5.36 / $9.52	Professional	26	$4.83	$5.36	$9.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.14 / $36.79 / $89.93	Professional		$28.14	$36.79	$89.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.00 / $6.32 / $15.43	Professional	26	$5.00	$6.32	$15.43
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.21 / $53.52 / $123.09	Professional	50	$42.21	$53.52	$123.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.30 / $29.55 / $65.40	Professional	TC	$23.30	$29.55	$65.40
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $9.74 / $42.39 / $52.13	Professional		$9.74	$42.39	$52.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.66 / $7.66 / $7.66	Facility	26	$7.66	$7.66	$7.66
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.40 / $35.40 / $35.40	Facility	TC	$35.40	$35.40	$35.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.40 / $49.27 / $124.07	Professional		$27.40	$49.27	$124.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $4.94 / $9.33 / $20.61	Professional	26	$4.94	$9.33	$20.61
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.71 / $43.71 / $49.70	Professional	50	$43.71	$43.71	$49.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.72 / $38.29 / $103.57	Professional	TC	$19.72	$38.29	$103.57
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $32.56 / $45.09 / $77.84	Professional		$32.56	$45.09	$77.84
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.28 / $8.84 / $15.45	Professional	26	$6.28	$8.84	$15.45
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.34 / $42.18 / $67.89	Professional	TC	$32.34	$42.18	$67.89
Excellus BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $4.55 / $4.55 / $4.55	Facility	TC	$4.55	$4.55	$4.55
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.36 / $44.79 / $80.27	Professional		$21.36	$44.79	$80.27
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $3.70 / $8.80 / $14.26	Professional	26	$3.70	$8.80	$14.26
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.66 / $36.83 / $66.01	Professional	TC	$17.66	$36.83	$66.01
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $34.28 / $41.88 / $71.73	Professional		$34.28	$41.88	$71.73
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $5.01 / $5.01	Professional	26	$5.01	$5.01	$5.01
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $28.65 / $134.75 / $318.58	Facility	TC	$28.65	$134.75	$318.58
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.72 / $49.45 / $60.70	Professional		$34.72	$49.45	$60.70
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.84 / $9.50 / $16.10	Professional	26	$7.84	$9.50	$16.10
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $101.92 / $101.92 / $121.38	Professional	50	$101.92	$101.92	$121.38
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.66 / $48.66 / $48.66	Professional	TC	$48.66	$48.66	$48.66
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $7.66 / $7.66 / $7.66	Facility	26	$7.66	$7.66	$7.66
MVP Health Care Facility/Professional Facility Modifier TC Low / Median / High Price $35.40 / $35.40 / $35.40	Facility	TC	$35.40	$35.40	$35.40
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $27.38 / $48.59 / $115.93	Professional		$27.38	$48.59	$115.93
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $5.23 / $9.22 / $20.46	Professional	26	$5.23	$9.22	$20.46
MVP Health Care Facility/Professional Professional Modifier 50 Low / Median / High Price $43.71 / $43.71 / $49.70	Professional	50	$43.71	$43.71	$49.70
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $22.16 / $37.22 / $97.99	Professional	TC	$22.16	$37.22	$97.99
United Facility/Professional Professional Modifier Low / Median / High Price $27.26 / $36.11 / $79.37	Professional		$27.26	$36.11	$79.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.46 / $7.33 / $15.40	Professional	26	$5.46	$7.33	$15.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.09 / $30.31 / $67.83	Professional	TC	$23.09	$30.31	$67.83
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $7.82 / $7.82 / $20.95	Facility	26	$7.82	$7.82	$20.95
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $36.22 / $36.22 / $60.08	Facility	TC	$36.22	$36.22	$60.08
Univera Facility/Professional Professional Modifier Low / Median / High Price $21.36 / $56.19 / $96.74	Professional		$21.36	$56.19	$96.74
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $3.70 / $9.98 / $17.92	Professional	26	$3.70	$9.98	$17.92
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $17.66 / $45.50 / $79.56	Professional	TC	$17.66	$45.50	$79.56