Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.75 / $12.45 / $29.86	Facility	26	$8.75	$12.45	$29.86
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.06 / $81.34 / $333.43	Facility	TC	$25.06	$81.34	$333.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.14 / $37.29 / $93.93	Professional		$26.14	$37.29	$93.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.75 / $11.90 / $27.19	Professional	26	$8.75	$11.90	$27.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.39 / $24.00 / $57.61	Professional	TC	$17.39	$24.00	$57.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.18 / $25.45 / $29.08	Professional		$24.18	$25.45	$29.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.09 / $8.73 / $15.71	Professional	26	$8.09	$8.73	$15.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.17 / $27.68 / $84.42	Professional		$21.17	$27.68	$84.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.99 / $7.84 / $24.40	Professional	26	$5.99	$7.84	$24.40
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.17 / $19.84 / $54.25	Professional	TC	$15.17	$19.84	$54.25
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $16.17 / $35.71 / $51.88	Professional		$16.17	$35.71	$51.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.57 / $48.84 / $113.34	Professional		$27.57	$48.84	$113.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.07 / $15.03 / $32.68	Professional	26	$8.07	$15.03	$32.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.41 / $33.28 / $80.11	Professional	TC	$19.41	$33.28	$80.11
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $34.31 / $44.87 / $75.48	Professional		$34.31	$44.87	$75.48
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.44 / $14.32 / $22.97	Professional	26	$10.44	$14.32	$22.97
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.56 / $34.61 / $55.83	Professional	TC	$26.56	$34.61	$55.83
Excellus BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $9.09 / $9.09 / $9.09	Facility	TC	$9.09	$9.09	$9.09
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.58 / $43.06 / $77.16	Professional		$28.58	$43.06	$77.16
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.21 / $14.58 / $22.99	Professional	26	$9.21	$14.58	$22.99
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.61 / $30.23 / $54.17	Professional	TC	$18.61	$30.23	$54.17
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $37.90 / $40.40 / $68.90	Professional		$37.90	$40.40	$68.90
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $9.75 / $9.75 / $9.75	Professional	26	$9.75	$9.75	$9.75
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $25.51 / $65.14 / $304.02	Facility	TC	$25.51	$65.14	$304.02
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.38 / $48.04 / $88.79	Professional		$35.38	$48.04	$88.79
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.87 / $13.06 / $26.98	Professional	26	$11.87	$13.06	$26.98
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.72 / $60.72 / $60.72	Professional	TC	$60.72	$60.72	$60.72
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
MVP Health Care Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $29.23 / $48.51 / $106.37	Professional		$29.23	$48.51	$106.37
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $8.53 / $15.06 / $32.68	Professional	26	$8.53	$15.06	$32.68
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $19.73 / $32.34 / $72.56	Professional	TC	$19.73	$32.34	$72.56
United Facility/Professional Professional Modifier Low / Median / High Price $30.17 / $37.29 / $79.56	Professional		$30.17	$37.29	$79.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.31 / $11.91 / $25.61	Professional	26	$9.31	$11.91	$25.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.05 / $25.10 / $51.97	Professional	TC	$20.05	$25.10	$51.97
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $12.62 / $12.62 / $18.01	Facility	26	$12.62	$12.62	$18.01
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $29.73 / $29.73 / $32.56	Facility	TC	$29.73	$29.73	$32.56
Univera Facility/Professional Professional Modifier Low / Median / High Price $28.58 / $54.51 / $93.00	Professional		$28.58	$54.51	$93.00
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $9.82 / $16.57 / $27.71	Professional	26	$9.82	$16.57	$27.71
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $18.76 / $37.92 / $65.29	Professional	TC	$18.76	$37.92	$65.29