Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.46 / $33.03 / $92.23	Facility	26	$22.46	$33.03	$92.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.28 / $57.97 / $144.83	Professional		$42.28	$57.97	$144.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.47 / $33.96 / $78.11	Professional	26	$22.47	$33.96	$78.11
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $29.12 / $53.75 / $228.00	Professional	52	$29.12	$53.75	$228.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $25.32 / $61.80	Professional	TC	$19.80	$25.32	$61.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.59 / $41.24 / $48.69	Professional		$34.59	$41.24	$48.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.05 / $25.49 / $40.54	Professional	26	$21.05	$25.49	$40.54
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $10.29 / $10.29 / $36.03	Professional	52	$10.29	$10.29	$36.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $27.91 / $27.91 / $27.91	Professional	TC	$27.91	$27.91	$27.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.13 / $59.00 / $140.90	Professional		$45.13	$59.00	$140.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.36 / $31.12 / $66.81	Professional	26	$24.36	$31.12	$66.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.76 / $26.33 / $59.81	Professional	TC	$20.76	$26.33	$59.81
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $42.00 / $76.86	Professional		$34.85	$42.00	$76.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.55 / $74.58 / $164.20	Professional		$41.55	$74.58	$164.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.17 / $39.50 / $86.95	Professional	26	$21.17	$39.50	$86.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.88 / $35.29 / $77.20	Professional	TC	$18.88	$35.29	$77.20
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $52.40 / $70.17 / $107.73	Professional		$52.40	$70.17	$107.73
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.87 / $36.96 / $59.11	Professional	26	$26.87	$36.96	$59.11
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.47 / $32.04 / $51.15	Professional	TC	$24.47	$32.04	$51.15
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.57 / $61.62 / $110.43	Professional		$42.57	$61.62	$110.43
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.02 / $37.61 / $60.28	Professional	26	$24.02	$37.61	$60.28
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $27.99 / $50.15	Professional	TC	$19.32	$27.99	$50.15
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $51.96 / $54.84 / $96.53	Professional		$51.96	$54.84	$96.53
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $24.19 / $27.52 / $33.65	Professional	26	$24.19	$27.52	$33.65
Fidelis Facility/Professional Professional Modifier 52 Low / Median / High Price $26.29 / $26.29 / $26.29	Professional	52	$26.29	$26.29	$26.29
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.58 / $64.77 / $104.39	Professional		$54.58	$64.77	$104.39
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.25 / $36.11 / $60.19	Professional	26	$30.25	$36.11	$60.19
Highmark BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $27.48 / $34.81 / $57.94	Professional	52	$27.48	$34.81	$57.94
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.31 / $30.85 / $31.77	Professional	TC	$24.31	$30.85	$31.77
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $39.65 / $74.92 / $164.20	Professional		$39.65	$74.92	$164.20
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $22.00 / $38.83 / $85.88	Professional	26	$22.00	$38.83	$85.88
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $19.68 / $34.04 / $77.20	Professional	TC	$19.68	$34.04	$77.20
United Facility/Professional Professional Modifier Low / Median / High Price $43.88 / $59.39 / $121.48	Professional		$43.88	$59.39	$121.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.41 / $32.72 / $66.89	Professional	26	$21.41	$32.72	$66.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.21 / $26.52 / $58.77	Professional	TC	$20.21	$26.52	$58.77
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $30.34 / $30.34 / $48.03	Facility	26	$30.34	$30.34	$48.03
Univera Facility/Professional Professional Modifier Low / Median / High Price $47.29 / $77.79 / $133.09	Professional		$47.29	$77.79	$133.09
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $25.58 / $42.69 / $72.65	Professional	26	$25.58	$42.69	$72.65
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $21.71 / $34.70 / $60.44	Professional	TC	$21.71	$34.70	$60.44