Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.60 / $28.82 / $61.37	Facility	26	$18.60	$28.82	$61.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.66 / $56.86 / $181.60	Professional		$27.66	$56.86	$181.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.17 / $33.15 / $92.52	Professional	26	$17.17	$33.15	$92.52
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $236.80 / $236.80 / $236.80	Professional	50	$236.80	$236.80	$236.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.07 / $13.54 / $70.00	Professional	TC	$9.07	$13.54	$70.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.61 / $50.57 / $107.92	Professional		$42.61	$50.57	$107.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.96 / $25.45 / $46.80	Professional	26	$23.96	$25.45	$46.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.44 / $55.96 / $106.11	Professional		$45.44	$55.96	$106.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.30 / $23.22 / $57.42	Professional	26	$18.30	$23.22	$57.42
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $69.34 / $83.83 / $152.71	Professional	50	$69.34	$83.83	$152.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $33.32 / $55.92	Professional	TC	$18.53	$33.32	$55.92
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $33.36 / $46.21 / $79.58	Professional		$33.36	$46.21	$79.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.43 / $37.43 / $37.43	Facility	26	$37.43	$37.43	$37.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.46 / $61.40 / $191.05	Professional		$33.46	$61.40	$191.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.17 / $34.32 / $74.28	Professional	26	$18.17	$34.32	$74.28
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $74.87 / $74.87 / $74.87	Professional	50	$74.87	$74.87	$74.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.26 / $28.84 / $105.35	Professional	TC	$11.26	$28.84	$105.35
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $39.26 / $78.17 / $132.07	Professional		$39.26	$78.17	$132.07
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $42.78 / $68.06	Professional	26	$28.84	$42.78	$68.06
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.39 / $42.18 / $64.18	Professional	TC	$33.39	$42.18	$64.18
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $74.84 / $131.94	Professional		$20.00	$74.84	$131.94
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.72 / $43.32 / $69.51	Professional	26	$12.72	$43.32	$69.51
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $7.28 / $36.06 / $63.56	Professional	TC	$7.28	$36.06	$63.56
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $64.92 / $67.76 / $69.40	Professional		$64.92	$67.76	$69.40
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $16.82 / $31.79 / $38.86	Professional	26	$16.82	$31.79	$38.86
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.55 / $62.95 / $84.05	Professional		$55.55	$62.95	$84.05
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.22 / $27.70 / $56.01	Professional	26	$27.22	$27.70	$56.01
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $60.37 / $60.37 / $60.37	Professional	50	$60.37	$60.37	$60.37
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.15 / $32.15 / $32.15	Professional	TC	$32.15	$32.15	$32.15
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $37.43 / $37.43 / $37.43	Facility	26	$37.43	$37.43	$37.43
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $27.22 / $69.47 / $163.02	Professional		$27.22	$69.47	$163.02
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $20.21 / $33.24 / $67.02	Professional	26	$20.21	$33.24	$67.02
MVP Health Care Facility/Professional Professional Modifier 50 Low / Median / High Price $74.87 / $74.87 / $74.87	Professional	50	$74.87	$74.87	$74.87
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $12.73 / $40.58 / $86.07	Professional	TC	$12.73	$40.58	$86.07
United Facility/Professional Professional Modifier Low / Median / High Price $33.65 / $54.30 / $124.27	Professional		$33.65	$54.30	$124.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.48 / $24.93 / $59.66	Professional	26	$18.48	$24.93	$59.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.12 / $30.83 / $73.15	Professional	TC	$14.12	$30.83	$73.15
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $38.14 / $38.14 / $44.11	Facility	26	$38.14	$38.14	$44.11
Univera Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $83.66 / $160.72	Professional		$20.00	$83.66	$160.72
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $12.72 / $43.32 / $83.77	Professional	26	$12.72	$43.32	$83.77
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $7.28 / $40.54 / $77.44	Professional	TC	$7.28	$40.54	$77.44