Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.55 / $38.10 / $93.51	Facility	26	$27.55	$38.10	$93.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.17 / $108.26 / $276.52	Professional		$72.17	$108.26	$276.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.55 / $35.59 / $84.06	Professional	26	$27.55	$35.59	$84.06
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $88.83 / $236.31 / $694.50	Professional	50	$88.83	$236.31	$694.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.92 / $70.84 / $133.97	Professional	TC	$55.92	$70.84	$133.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.05 / $76.56 / $102.40	Professional		$60.05	$76.56	$102.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.39 / $40.46 / $58.44	Professional	26	$19.39	$40.46	$58.44
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $100.08 / $119.18 / $275.62	Professional	50	$100.08	$119.18	$275.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.53 / $121.12 / $270.91	Professional		$97.53	$121.12	$270.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.05 / $38.57 / $82.88	Professional	26	$31.05	$38.57	$82.88
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $146.30 / $181.68 / $399.01	Professional	50	$146.30	$181.68	$399.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.47 / $82.55 / $171.94	Professional	TC	$66.47	$82.55	$171.94
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $50.41 / $99.69 / $150.10	Professional		$50.41	$99.69	$150.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.72 / $39.72 / $39.72	Facility	26	$39.72	$39.72	$39.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.93 / $154.16 / $326.48	Professional		$81.93	$154.16	$326.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.94 / $49.94 / $105.26	Professional	26	$26.94	$49.94	$105.26
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $138.68 / $138.68 / $138.68	Professional	50	$138.68	$138.68	$138.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.54 / $104.17 / $222.47	Professional	TC	$54.54	$104.17	$222.47
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $104.78 / $137.44 / $208.54	Professional		$104.78	$137.44	$208.54
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.85 / $45.34 / $72.27	Professional	26	$32.85	$45.34	$72.27
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.78 / $89.81 / $136.27	Professional	TC	$70.78	$89.81	$136.27
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.63 / $120.79 / $216.48	Professional		$77.63	$120.79	$216.48
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.57 / $45.99 / $73.84	Professional	26	$25.57	$45.99	$73.84
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.07 / $79.59 / $142.63	Professional	TC	$52.07	$79.59	$142.63
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $102.44 / $104.08 / $110.90	Professional		$102.44	$104.08	$110.90
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $32.07 / $47.31 / $65.97	Professional	26	$32.07	$47.31	$65.97
Fidelis Facility/Professional Professional Modifier 50 Low / Median / High Price $144.08 / $168.10 / $303.30	Professional	50	$144.08	$168.10	$303.30
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.78 / $124.91 / $188.13	Professional		$107.78	$124.91	$188.13
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.01 / $61.52 / $89.18	Professional	26	$41.01	$61.52	$89.18
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $109.61 / $176.04 / $287.89	Professional	50	$109.61	$176.04	$287.89
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $104.99 / $136.69 / $140.79	Professional	TC	$104.99	$136.69	$140.79
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $39.72 / $39.72 / $39.72	Facility	26	$39.72	$39.72	$39.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $79.72 / $149.65 / $325.41	Professional		$79.72	$149.65	$325.41
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $28.02 / $49.21 / $102.95	Professional	26	$28.02	$49.21	$102.95
MVP Health Care Facility/Professional Professional Modifier 50 Low / Median / High Price $138.68 / $138.68 / $138.68	Professional	50	$138.68	$138.68	$138.68
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $59.86 / $98.05 / $218.89	Professional	TC	$59.86	$98.05	$218.89
United Facility/Professional Professional Modifier Low / Median / High Price $84.62 / $108.99 / $234.16	Professional		$84.62	$108.99	$234.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.61 / $38.15 / $87.61	Professional	26	$27.61	$38.15	$87.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.52 / $75.09 / $158.01	Professional	TC	$56.52	$75.09	$158.01
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $40.52 / $40.52 / $59.77	Facility	26	$40.52	$40.52	$59.77
Univera Facility/Professional Professional Modifier Low / Median / High Price $77.63 / $137.27 / $260.89	Professional		$77.63	$137.27	$260.89
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $25.57 / $46.82 / $88.99	Professional	26	$25.57	$46.82	$88.99
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $52.07 / $90.45 / $171.90	Professional	TC	$52.07	$90.45	$171.90