Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.16 / $62.51 / $1,008.50	Facility		$28.16	$62.51	$1,008.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.89 / $17.10 / $36.40	Facility	26	$10.89	$17.10	$36.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.28 / $37.56 / $78.48	Professional		$24.28	$37.56	$78.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.89 / $14.68 / $55.54	Professional	26	$10.89	$14.68	$55.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.39 / $22.27 / $46.85	Professional	TC	$13.39	$22.27	$46.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.00 / $66.00 / $66.00	Professional		$66.00	$66.00	$66.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.42 / $11.92 / $20.10	Professional	26	$9.42	$11.92	$20.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.27 / $41.32 / $88.55	Professional		$33.27	$41.32	$88.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.01 / $14.40 / $33.22	Professional	26	$11.01	$14.40	$33.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.76 / $26.81 / $52.56	Professional	TC	$21.76	$26.81	$52.56
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $19.57 / $19.57 / $34.38	Facility		$19.57	$19.57	$34.38
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $19.57 / $34.38 / $53.95	Professional		$19.57	$34.38	$53.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.87 / $42.87 / $218.93	Facility		$42.87	$42.87	$218.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.88 / $15.88 / $15.88	Facility	26	$15.88	$15.88	$15.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.13 / $53.25 / $125.26	Professional		$29.13	$53.25	$125.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.60 / $21.06 / $42.38	Professional	26	$10.60	$21.06	$42.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.55 / $32.27 / $93.20	Professional	TC	$17.55	$32.27	$93.20
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $21.23 / $37.86 / $332.00	Facility		$21.23	$37.86	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $35.45 / $48.05 / $78.30	Professional		$35.45	$48.05	$78.30
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.63 / $17.05 / $27.79	Professional	26	$12.63	$17.05	$27.79
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.54 / $32.67 / $50.49	Professional	TC	$25.54	$32.67	$50.49
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $55.55 / $55.55 / $55.55	Facility		$55.55	$55.55	$55.55
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.39 / $49.82 / $76.67	Professional		$23.39	$49.82	$76.67
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.31 / $17.69 / $28.73	Professional	26	$8.31	$17.69	$28.73
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.09 / $32.13 / $48.89	Professional	TC	$15.09	$32.13	$48.89
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $39.11 / $39.11 / $47.16	Professional		$39.11	$39.11	$47.16
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $11.89 / $11.89 / $15.86	Professional	26	$11.89	$11.89	$15.86
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.80 / $257.94 / $1,394.20	Facility		$74.80	$257.94	$1,394.20
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.68 / $38.77 / $41.54	Professional		$36.68	$38.77	$41.54
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.91 / $17.80 / $33.88	Professional	26	$14.91	$17.80	$33.88
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $42.87 / $105.94 / $555.00	Facility		$42.87	$105.94	$555.00
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $15.88 / $15.88 / $15.88	Facility	26	$15.88	$15.88	$15.88
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $32.71 / $51.78 / $116.50	Professional		$32.71	$51.78	$116.50
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $11.01 / $20.36 / $40.29	Professional	26	$11.01	$20.36	$40.29
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $29.80 / $89.73	Professional	TC	$19.50	$29.80	$89.73
United Facility/Professional Professional Modifier Low / Median / High Price $28.75 / $35.71 / $78.56	Professional		$28.75	$35.71	$78.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.10 / $14.80 / $32.38	Professional	26	$11.10	$14.80	$32.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.21 / $22.37 / $50.09	Professional	TC	$18.21	$22.37	$50.09
Univera Facility/Professional Facility Modifier Low / Median / High Price $44.22 / $44.22 / $105.80	Facility		$44.22	$44.22	$105.80
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $16.03 / $16.03 / $49.76	Facility	26	$16.03	$16.03	$49.76
Univera Facility/Professional Professional Modifier Low / Median / High Price $23.39 / $51.10 / $97.12	Professional		$23.39	$51.10	$97.12
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $8.31 / $18.52 / $35.20	Professional	26	$8.31	$18.52	$35.20
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $15.09 / $32.59 / $61.93	Professional	TC	$15.09	$32.59	$61.93