Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.11 / $9.51 / $20.94	Facility	26	$6.11	$9.51	$20.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.03 / $31.51 / $76.34	Professional		$21.03	$31.51	$76.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.11 / $8.22 / $25.88	Professional	26	$6.11	$8.22	$25.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $66.28 / $115.23 / $115.72	Professional	50	$66.28	$115.23	$115.72
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.49 / $13.82 / $24.66	Professional	52	$10.49	$13.82	$24.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.93 / $21.17 / $51.04	Professional	TC	$14.93	$21.17	$51.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.55 / $19.57 / $22.36	Professional		$18.55	$19.57	$22.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.74 / $5.99 / $10.98	Professional	26	$5.74	$5.99	$10.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.62 / $28.15 / $70.65	Professional		$21.62	$28.15	$70.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.47 / $7.16 / $17.34	Professional	26	$5.47	$7.16	$17.34
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $32.29 / $42.22 / $100.50	Professional	50	$32.29	$42.22	$100.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.05 / $20.36 / $47.12	Professional	TC	$16.05	$20.36	$47.12
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $11.24 / $29.02 / $40.26	Professional		$11.24	$29.02	$40.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.67 / $39.22 / $102.88	Professional		$22.67	$39.22	$102.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.66 / $10.78 / $23.54	Professional	26	$5.66	$10.78	$23.54
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.13 / $35.13 / $39.76	Professional	50	$35.13	$35.13	$39.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.30 / $30.15 / $76.88	Professional	TC	$16.30	$30.15	$76.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $26.26 / $33.44 / $57.68	Professional		$26.26	$33.44	$57.68
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.25 / $10.07 / $15.95	Professional	26	$7.25	$10.07	$15.95
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.12 / $27.49 / $44.46	Professional	TC	$21.12	$27.49	$44.46
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $33.58 / $60.19	Professional		$19.00	$33.58	$60.19
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.44 / $10.16 / $16.46	Professional	26	$4.44	$10.16	$16.46
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.55 / $24.40 / $43.72	Professional	TC	$14.55	$24.40	$43.72
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.60 / $39.19 / $51.39	Professional		$29.60	$39.19	$51.39
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.05 / $9.15 / $18.10	Professional	26	$9.05	$9.15	$18.10
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $73.40 / $73.40 / $73.40	Professional	50	$73.40	$73.40	$73.40
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $24.72 / $39.11 / $89.01	Professional		$24.72	$39.11	$89.01
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $5.97 / $10.55 / $23.17	Professional	26	$5.97	$10.55	$23.17
MVP Health Care Facility/Professional Professional Modifier 50 Low / Median / High Price $35.13 / $35.13 / $39.76	Professional	50	$35.13	$35.13	$39.76
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $16.52 / $26.53 / $67.17	Professional	TC	$16.52	$26.53	$67.17
United Facility/Professional Professional Modifier Low / Median / High Price $23.15 / $29.94 / $60.81	Professional		$23.15	$29.94	$60.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.25 / $8.30 / $17.78	Professional	26	$6.25	$8.30	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.55 / $21.22 / $44.70	Professional	TC	$16.55	$21.22	$44.70
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $9.02 / $9.02 / $25.70	Facility	26	$9.02	$9.02	$25.70
Univera Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $41.64 / $74.63	Professional		$19.00	$41.64	$74.63
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $4.44 / $11.52 / $20.68	Professional	26	$4.44	$11.52	$20.68
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $14.55 / $30.12 / $55.04	Professional	TC	$14.55	$30.12	$55.04