Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $9.77 / $20.42 / $363.08	Facility		$9.77	$20.42	$363.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.88 / $5.25 / $5.25	Facility	26	$2.88	$5.25	$5.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $19.05 / $44.67	Professional		$10.00	$19.05	$44.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.88 / $6.92 / $15.14	Professional	26	$2.88	$6.92	$15.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $6.92 / $12.02 / $26.92	Professional	TC	$6.92	$12.02	$26.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $14.79 / $14.79	Professional		$14.79	$14.79	$14.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.27 / $4.27 / $4.27	Professional	26	$4.27	$4.27	$4.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $17.78 / $53.70	Professional		$11.22	$17.78	$53.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $1.86 / $5.50 / $15.14	Professional	26	$1.86	$5.50	$15.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.55 / $12.02 / $39.81	Professional	TC	$9.55	$12.02	$39.81
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $2.63 / $6.31 / $15.14	Facility		$2.63	$6.31	$15.14
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $6.31 / $10.96 / $21.38	Professional		$6.31	$10.96	$21.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $29.51 / $35.48	Facility		$24.55	$29.51	$35.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.05 / $4.90 / $6.92	Facility	26	$1.05	$4.90	$6.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $19.95 / $69.18	Professional		$9.55	$19.95	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.45 / $5.62 / $14.79	Professional	26	$2.45	$5.62	$14.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $6.76 / $14.45 / $51.29	Professional	TC	$6.76	$14.45	$51.29
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $2.51 / $2.51 / $2.51	Facility		$2.51	$2.51	$2.51
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $16.60 / $32.36	Professional		$12.59	$16.60	$32.36
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.24 / $5.13 / $21.38	Professional	26	$3.24	$5.13	$21.38
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $9.33 / $13.18 / $21.38	Professional	TC	$9.33	$13.18	$21.38
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $19.50 / $31.62	Professional		$13.18	$19.50	$31.62
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $3.55 / $5.25 / $8.51	Professional	26	$3.55	$5.25	$8.51
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.55 / $14.45 / $22.91	Professional	TC	$9.55	$14.45	$22.91
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $7.08 / $7.08	Professional	26	$7.08	$7.08	$7.08
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $28.18 / $29.51	Professional		$28.18	$28.18	$29.51
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.47 / $4.57 / $8.91	Professional	26	$4.47	$4.57	$8.91
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $16.22 / $17.78	Professional		$16.22	$16.22	$17.78
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $4.37 / $4.37 / $5.25	Professional	26	$4.37	$4.37	$5.25
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $12.02 / $14.45	Professional	TC	$12.02	$12.02	$14.45
United Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $11.48 / $29.51	Professional		$8.51	$11.48	$29.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.24 / $3.16 / $8.32	Professional	26	$2.24	$3.16	$8.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $6.17 / $8.32 / $22.39	Professional	TC	$6.17	$8.32	$22.39
Univera Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $17.38 / $33.88	Professional		$13.18	$17.38	$33.88
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $3.55 / $4.68 / $9.12	Professional	26	$3.55	$4.68	$9.12
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $9.55 / $12.88 / $25.12	Professional	TC	$9.55	$12.88	$25.12