Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.67 / $49.23 / $517.59	Facility		$24.67	$49.23	$517.59
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.47 / $5.47 / $10.03	Facility	26	$5.47	$5.47	$10.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.91 / $41.33 / $82.65	Professional		$20.91	$41.33	$82.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $4.61 / $9.61 / $28.14	Professional	26	$4.61	$9.61	$28.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.30 / $31.72 / $64.06	Professional	TC	$16.30	$31.72	$64.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.49 / $29.49 / $29.49	Professional		$29.49	$29.49	$29.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.32 / $6.32 / $6.32	Professional	26	$6.32	$6.32	$6.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.33 / $37.22 / $100.64	Professional		$22.33	$37.22	$100.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $3.02 / $8.48 / $21.12	Professional	26	$3.02	$8.48	$21.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.73 / $29.22 / $78.34	Professional	TC	$19.73	$29.22	$78.34
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $4.08 / $9.74 / $34.27	Facility		$4.08	$9.74	$34.27
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $9.74 / $22.43 / $44.01	Professional		$9.74	$22.43	$44.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.73 / $62.32 / $74.45	Facility		$51.73	$62.32	$74.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.31 / $9.31 / $9.31	Facility	26	$9.31	$9.31	$9.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.10 / $38.19 / $97.43	Professional		$19.10	$38.19	$97.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.62 / $8.40 / $18.98	Professional	26	$3.62	$8.40	$18.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.72 / $29.97 / $81.83	Professional	TC	$14.72	$29.97	$81.83
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $5.00 / $5.00 / $5.00	Facility		$5.00	$5.00	$5.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $21.20 / $35.63 / $75.09	Professional		$21.20	$35.63	$75.09
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $4.87 / $6.96 / $12.56	Professional	26	$4.87	$6.96	$12.56
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.05 / $25.96 / $46.53	Professional	TC	$17.05	$25.96	$46.53
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.73 / $46.62 / $69.81	Professional		$24.73	$46.62	$69.81
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.55 / $9.52 / $26.06	Professional	26	$5.55	$9.52	$26.06
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.17 / $37.10 / $55.57	Professional	TC	$19.17	$37.10	$55.57
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $20.48 / $20.48 / $20.48	Professional		$20.48	$20.48	$20.48
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $8.74 / $8.74 / $8.74	Professional	26	$8.74	$8.74	$8.74
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.49 / $31.49 / $31.49	Professional		$31.49	$31.49	$31.49
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.90 / $7.05 / $13.49	Professional	26	$6.90	$7.05	$13.49
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $62.32 / $62.32 / $74.45	Facility		$62.32	$62.32	$74.45
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $9.31 / $9.31 / $9.31	Facility	26	$9.31	$9.31	$9.31
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $19.10 / $33.60 / $100.24	Professional		$19.10	$33.60	$100.24
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $3.63 / $7.00 / $15.71	Professional	26	$3.63	$7.00	$15.71
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $14.68 / $27.37 / $80.44	Professional	TC	$14.68	$27.37	$80.44
United Facility/Professional Professional Modifier Low / Median / High Price $16.96 / $22.91 / $62.68	Professional		$16.96	$22.91	$62.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.46 / $4.88 / $12.73	Professional	26	$3.46	$4.88	$12.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.29 / $18.27 / $48.26	Professional	TC	$13.29	$18.27	$48.26
Univera Facility/Professional Professional Modifier Low / Median / High Price $30.77 / $44.29 / $84.15	Professional		$30.77	$44.29	$84.15
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $6.28 / $9.52 / $18.36	Professional	26	$6.28	$9.52	$18.36
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $24.49 / $32.97 / $66.97	Professional	TC	$24.49	$32.97	$66.97