Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.28 / $11.61 / $25.35	Facility	26	$9.28	$11.61	$25.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.82 / $41.44 / $146.36	Professional		$23.82	$41.44	$146.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.83 / $10.42 / $32.67	Professional	26	$8.83	$10.42	$32.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.96 / $24.22 / $93.28	Professional	TC	$13.96	$24.22	$93.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.89 / $16.89 / $16.89	Professional		$16.89	$16.89	$16.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.87 / $8.39 / $19.21	Professional	26	$6.87	$8.39	$19.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.18 / $25.08 / $127.62	Professional		$19.18	$25.08	$127.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.48 / $9.77 / $22.18	Professional	26	$7.48	$9.77	$22.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $11.70 / $15.30 / $83.57	Professional	TC	$11.70	$15.30	$83.57
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $13.72 / $18.04 / $31.76	Professional		$13.72	$18.04	$31.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $5.59 / $5.59 / $5.59	Facility	53	$5.59	$5.59	$5.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.17 / $50.91 / $210.50	Professional		$19.17	$50.91	$210.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.83 / $13.18 / $28.52	Professional	26	$6.83	$13.18	$28.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.74 / $32.60 / $169.17	Professional	TC	$10.74	$32.60	$169.17
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $26.52 / $37.95 / $132.76	Professional		$26.52	$37.95	$132.76
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.85 / $12.17 / $19.47	Professional	26	$8.85	$12.17	$19.47
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $16.70 / $21.71 / $35.15	Professional	TC	$16.70	$21.71	$35.15
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.83 / $46.10 / $63.63	Professional		$23.83	$46.10	$63.63
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.57 / $12.40 / $20.09	Professional	26	$5.57	$12.40	$20.09
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.97 / $28.52 / $45.10	Professional	TC	$14.97	$28.52	$45.10
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $25.83 / $32.01 / $55.90	Professional		$25.83	$32.01	$55.90
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $6.96 / $10.43 / $11.25	Professional	26	$6.96	$10.43	$11.25
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.44 / $30.65 / $36.94	Professional		$25.44	$30.65	$36.94
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.91 / $11.17 / $18.51	Professional	26	$9.91	$11.17	$18.51
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.07 / $18.07 / $18.07	Professional	TC	$18.07	$18.07	$18.07
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $5.59 / $5.59 / $5.59	Facility	53	$5.59	$5.59	$5.59
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $22.15 / $41.26 / $191.44	Professional		$22.15	$41.26	$191.44
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $7.23 / $12.95 / $27.85	Professional	26	$7.23	$12.95	$27.85
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $12.33 / $21.87 / $134.40	Professional	TC	$12.33	$21.87	$134.40
United Facility/Professional Professional Modifier Low / Median / High Price $20.23 / $30.97 / $131.01	Professional		$20.23	$30.97	$131.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.03 / $10.59 / $24.19	Professional	26	$8.03	$10.59	$24.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $16.77 / $66.73	Professional	TC	$11.48	$16.77	$66.73
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $11.03 / $11.03 / $33.00	Facility	26	$11.03	$11.03	$33.00
Univera Facility/Professional Professional Modifier Low / Median / High Price $25.08 / $37.85 / $63.63	Professional		$25.08	$37.85	$63.63
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $5.57 / $14.07 / $25.24	Professional	26	$5.57	$14.07	$25.24
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $15.51 / $23.78 / $43.32	Professional	TC	$15.51	$23.78	$43.32