Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.78 / $15.14 / $28.73	Facility	26	$10.78	$15.14	$28.73
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.14 / $53.48 / $194.87	Facility	TC	$24.14	$53.48	$194.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.65 / $41.89 / $99.37	Professional		$30.65	$41.89	$99.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.43 / $13.17 / $30.82	Professional	26	$10.43	$13.17	$30.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.22 / $27.96 / $56.30	Professional	TC	$20.22	$27.96	$56.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.01 / $32.01 / $32.01	Professional		$32.01	$32.01	$32.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.35 / $14.47 / $18.09	Professional	26	$9.35	$14.47	$18.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.75 / $32.36 / $98.70	Professional		$24.75	$32.36	$98.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.85 / $8.96 / $28.64	Professional	26	$6.85	$8.96	$28.64
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $23.10 / $63.15	Professional	TC	$17.89	$23.10	$63.15
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $18.64 / $41.44 / $60.09	Professional		$18.64	$41.44	$60.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $14.65	Facility	26	$14.65	$14.65	$14.65
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $33.92 / $33.92 / $33.92	Facility	TC	$33.92	$33.92	$33.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.27 / $56.77 / $127.34	Professional		$32.27	$56.77	$127.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.59 / $17.75 / $38.54	Professional	26	$9.59	$17.75	$38.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.61 / $39.03 / $91.47	Professional	TC	$22.61	$39.03	$91.47
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $39.60 / $52.44 / $87.12	Professional		$39.60	$52.44	$87.12
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.04 / $16.42 / $26.49	Professional	26	$12.04	$16.42	$26.49
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.64 / $39.96 / $64.34	Professional	TC	$30.64	$39.96	$64.34
Excellus BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $12.12 / $12.12 / $12.12	Facility	TC	$12.12	$12.12	$12.12
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.47 / $50.52 / $90.55	Professional		$33.47	$50.52	$90.55
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $16.86 / $27.32	Professional	26	$10.80	$16.86	$27.32
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.68 / $35.28 / $63.23	Professional	TC	$21.68	$35.28	$63.23
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $37.61 / $42.94 / $42.94	Professional		$37.61	$42.94	$42.94
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $29.02 / $79.51 / $428.80	Facility	TC	$29.02	$79.51	$428.80
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.60 / $41.65 / $57.22	Professional		$39.60	$41.65	$57.22
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.92 / $16.43 / $26.98	Professional	26	$13.92	$16.43	$26.98
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $14.65	Facility	26	$14.65	$14.65	$14.65
MVP Health Care Facility/Professional Facility Modifier TC Low / Median / High Price $33.92 / $33.92 / $33.92	Facility	TC	$33.92	$33.92	$33.92
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $30.42 / $56.57 / $119.53	Professional		$30.42	$56.57	$119.53
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $10.16 / $17.30 / $37.36	Professional	26	$10.16	$17.30	$37.36
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $23.28 / $37.99 / $83.00	Professional	TC	$23.28	$37.99	$83.00
United Facility/Professional Professional Modifier Low / Median / High Price $34.21 / $42.22 / $96.78	Professional		$34.21	$42.22	$96.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $13.71 / $29.85	Professional	26	$10.23	$13.71	$29.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.64 / $28.70 / $59.49	Professional	TC	$23.64	$28.70	$59.49
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $14.99 / $14.99 / $21.11	Facility	26	$14.99	$14.99	$21.11
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $34.70 / $34.70 / $37.94	Facility	TC	$34.70	$34.70	$37.94
Univera Facility/Professional Professional Modifier Low / Median / High Price $33.47 / $62.90 / $109.13	Professional		$33.47	$62.90	$109.13
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $11.66 / $19.13 / $32.93	Professional	26	$11.66	$19.13	$32.93
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $21.81 / $43.77 / $76.20	Professional	TC	$21.81	$43.77	$76.20