Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.08 / $7.43 / $14.86	Facility	26	$5.08	$7.43	$14.86
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.88 / $54.08 / $212.73	Facility	TC	$16.88	$54.08	$212.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.68 / $31.23 / $115.66	Professional		$19.68	$31.23	$115.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.08 / $6.63 / $17.39	Professional	26	$5.08	$6.63	$17.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.87 / $23.23 / $52.55	Professional	TC	$16.87	$23.23	$52.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.01 / $22.43 / $29.38	Professional		$20.01	$22.43	$29.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.66 / $5.47 / $12.36	Professional	26	$4.66	$5.47	$12.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.12 / $28.62 / $75.03	Professional		$22.12	$28.62	$75.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.58 / $5.99 / $14.38	Professional	26	$4.58	$5.99	$14.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.30 / $22.47 / $54.42	Professional	TC	$17.30	$22.47	$54.42
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $9.26 / $31.41 / $40.67	Professional		$9.26	$31.41	$40.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.31 / $7.31 / $7.31	Facility	26	$7.31	$7.31	$7.31
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $25.73 / $25.73 / $25.73	Facility	TC	$25.73	$25.73	$25.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.35 / $40.06 / $105.67	Professional		$23.35	$40.06	$105.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $4.70 / $8.84 / $19.42	Professional	26	$4.70	$8.84	$19.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $31.40 / $83.11	Professional	TC	$17.57	$31.40	$83.11
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $26.63 / $34.35 / $58.92	Professional		$26.63	$34.35	$58.92
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.04 / $8.38 / $13.16	Professional	26	$6.04	$8.38	$13.16
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.16 / $30.16 / $48.71	Professional	TC	$23.16	$30.16	$48.71
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 $19.96 / $34.29 / $61.47	Professional		$19.96	$34.29	$61.47
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $3.51 / $8.36 / $13.56	Professional	26	$3.51	$8.36	$13.56
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.45 / $26.73 / $47.90	Professional	TC	$16.45	$26.73	$47.90
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $31.98 / $37.03 / $37.03	Professional		$31.98	$37.03	$37.03
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $23.79 / $41.66 / $98.85	Facility	TC	$23.79	$41.66	$98.85
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.69 / $38.42 / $70.12	Professional		$30.69	$38.42	$70.12
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.75 / $7.53 / $13.37	Professional	26	$6.75	$7.53	$13.37
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.35 / $43.35 / $43.35	Professional	TC	$43.35	$43.35	$43.35
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $7.31 / $7.31 / $7.31	Facility	26	$7.31	$7.31	$7.31
MVP Health Care Facility/Professional Facility Modifier TC Low / Median / High Price $25.73 / $25.73 / $25.73	Facility	TC	$25.73	$25.73	$25.73
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $24.81 / $39.90 / $90.53	Professional		$24.81	$39.90	$90.53
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $4.96 / $8.75 / $19.38	Professional	26	$4.96	$8.75	$19.38
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $18.19 / $28.60 / $72.76	Professional	TC	$18.19	$28.60	$72.76
United Facility/Professional Professional Modifier Low / Median / High Price $21.74 / $28.77 / $60.70	Professional		$21.74	$28.77	$60.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.36 / $6.98 / $14.86	Professional	26	$5.36	$6.98	$14.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.73 / $22.28 / $47.88	Professional	TC	$17.73	$22.28	$47.88
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $7.44 / $7.44 / $20.95	Facility	26	$7.44	$7.44	$20.95
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $26.29 / $26.29 / $56.32	Facility	TC	$26.29	$26.29	$56.32
Univera Facility/Professional Professional Modifier Low / Median / High Price $19.96 / $42.54 / $76.22	Professional		$19.96	$42.54	$76.22
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $3.51 / $9.49 / $17.04	Professional	26	$3.51	$9.49	$17.04
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $16.45 / $33.04 / $59.40	Professional	TC	$16.45	$33.04	$59.40