Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.32 / $94.40 / $326.31	Facility		$26.32	$94.40	$326.31
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.91 / $9.52 / $20.42	Facility	26	$6.91	$9.52	$20.42
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.50 / $72.19 / $267.66	Facility	TC	$21.50	$72.19	$267.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.47 / $30.48 / $78.91	Professional		$21.47	$30.48	$78.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $9.38 / $29.75	Professional	26	$6.92	$9.38	$29.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.55 / $20.14 / $46.55	Professional	TC	$14.55	$20.14	$46.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.64 / $23.30 / $30.20	Professional		$19.64	$23.30	$30.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.42 / $8.24 / $17.84	Professional	26	$6.42	$8.24	$17.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.43 / $22.79 / $69.51	Professional		$17.43	$22.79	$69.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.76 / $6.24 / $19.48	Professional	26	$4.76	$6.24	$19.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.66 / $16.55 / $45.40	Professional	TC	$12.66	$16.55	$45.40
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $12.72 / $12.72 / $29.02	Facility		$12.72	$12.72	$29.02
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $12.72 / $29.02 / $41.74	Professional		$12.72	$29.02	$41.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.88 / $69.58 / $110.34	Facility		$43.88	$69.58	$110.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $24.24 / $24.24 / $24.24	Facility	TC	$24.24	$24.24	$24.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.65 / $39.89 / $91.88	Professional		$22.65	$39.89	$91.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.37 / $12.08 / $26.34	Professional	26	$6.37	$12.08	$26.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.25 / $27.81 / $65.84	Professional	TC	$16.25	$27.81	$65.84
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $18.12 / $32.31 / $332.00	Facility		$18.12	$32.31	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $27.78 / $36.76 / $61.12	Professional		$27.78	$36.76	$61.12
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.21 / $11.35 / $18.05	Professional	26	$8.21	$11.35	$18.05
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.80 / $28.39 / $45.88	Professional	TC	$21.80	$28.39	$45.88
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 $23.45 / $35.57 / $63.74	Professional		$23.45	$35.57	$63.74
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.23 / $11.49 / $18.63	Professional	26	$7.23	$11.49	$18.63
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.54 / $25.17 / $45.12	Professional	TC	$15.54	$25.17	$45.12
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $30.78 / $31.15 / $32.88	Professional		$30.78	$31.15	$32.88
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $6.48 / $6.48 / $6.48	Professional	26	$6.48	$6.48	$6.48
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.25 / $115.78 / $247.13	Facility		$25.25	$115.78	$247.13
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $20.25 / $52.63 / $260.95	Facility	TC	$20.25	$52.63	$260.95
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.44 / $32.22 / $46.00	Professional		$28.44	$32.22	$46.00
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.19 / $10.37 / $21.03	Professional	26	$9.19	$10.37	$21.03
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $37.61 / $69.69 / $201.15	Facility		$37.61	$69.69	$201.15
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
MVP Health Care Facility/Professional Facility Modifier TC Low / Median / High Price $24.24 / $24.24 / $24.24	Facility	TC	$24.24	$24.24	$24.24
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $23.90 / $39.61 / $87.27	Professional		$23.90	$39.61	$87.27
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $11.90 / $26.04	Professional	26	$6.74	$11.90	$26.04
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $16.43 / $26.89 / $60.43	Professional	TC	$16.43	$26.89	$60.43
United Facility/Professional Professional Modifier Low / Median / High Price $24.54 / $29.59 / $62.22	Professional		$24.54	$29.59	$62.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.31 / $9.85 / $24.03	Professional	26	$7.31	$9.85	$24.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.30 / $20.48 / $51.71	Professional	TC	$16.30	$20.48	$51.71
Univera Facility/Professional Facility Modifier Low / Median / High Price $34.97 / $34.97 / $41.34	Facility		$34.97	$34.97	$41.34
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $10.22 / $10.22 / $14.13	Facility	26	$10.22	$10.22	$14.13
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $24.76 / $24.76 / $27.21	Facility	TC	$24.76	$24.76	$27.21
Univera Facility/Professional Professional Modifier Low / Median / High Price $23.45 / $44.13 / $76.81	Professional		$23.45	$44.13	$76.81
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $7.75 / $13.04 / $22.45	Professional	26	$7.75	$13.04	$22.45
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $15.70 / $31.10 / $54.37	Professional	TC	$15.70	$31.10	$54.37