Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $16.22 / $30.20	Facility	26	$12.02	$16.22	$30.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.90 / $77.62 / $213.80	Facility	TC	$30.90	$77.62	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $47.86 / $154.88	Professional		$32.36	$47.86	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $16.98 / $38.02	Professional	26	$10.47	$16.98	$38.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $29.51 / $67.61	Professional	TC	$20.89	$29.51	$67.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $28.84 / $28.84	Professional		$28.84	$28.84	$28.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $10.00 / $22.39	Professional	26	$10.00	$10.00	$22.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $30.90 / $91.20	Professional		$24.55	$30.90	$91.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $8.51 / $26.30	Professional	26	$6.92	$8.51	$26.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $22.39 / $60.26	Professional	TC	$17.78	$22.39	$60.26
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $41.69 / $60.26	Professional		$18.62	$41.69	$60.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.09 / $14.45 / $20.89	Facility	26	$3.09	$14.45	$20.89
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.92 / $32.36 / $46.77	Facility	TC	$6.92	$32.36	$46.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $57.54 / $141.25	Professional		$32.36	$57.54	$141.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $18.62 / $44.67	Professional	26	$10.23	$18.62	$44.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $39.81 / $102.33	Professional	TC	$23.44	$39.81	$102.33
Emblem Health Facility/Professional Facility Modifier TC Low / Median / High Price $23.99 / $23.99 / $23.99	Facility	TC	$23.99	$23.99	$23.99
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $57.54 / $85.11	Professional		$43.65	$57.54	$85.11
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $18.20 / $35.48	Professional	26	$12.59	$18.20	$35.48
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $42.66 / $61.66	Professional	TC	$32.36	$42.66	$61.66
Excellus BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $12.02 / $12.02 / $12.02	Facility	TC	$12.02	$12.02	$12.02
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $54.95 / $100.00	Professional		$33.11	$54.95	$100.00
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $16.98 / $30.20	Professional	26	$11.75	$16.98	$30.20
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $38.90 / $70.79	Professional	TC	$21.88	$38.90	$70.79
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $27.54 / $74.13 / $426.58	Facility	TC	$27.54	$74.13	$426.58
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $41.69 / $58.88	Professional		$40.74	$41.69	$58.88
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $14.13 / $26.92	Professional	26	$13.80	$14.13	$26.92
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $56.23 / $112.20	Professional		$47.86	$56.23	$112.20
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $18.20 / $33.88	Professional	26	$15.14	$18.20	$33.88
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $38.02 / $79.43	Professional	TC	$32.36	$38.02	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $41.69 / $85.11	Professional		$32.36	$41.69	$85.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $13.49 / $26.92	Professional	26	$10.00	$13.49	$26.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.18 / $58.88	Professional	TC	$21.88	$28.18	$58.88
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $15.14 / $20.89	Facility	26	$10.47	$15.14	$20.89
Univera Facility/Professional Facility Modifier TC Low / Median / High Price $12.02 / $15.49 / $34.67	Facility	TC	$12.02	$15.49	$34.67
Univera Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $53.70 / $100.00	Professional		$33.11	$53.70	$100.00
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $16.98 / $32.36	Professional	26	$10.72	$16.98	$32.36
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $37.15 / $70.79	Professional	TC	$21.88	$37.15	$70.79