Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.46 / $194.38 / $1,409.69	Facility		$32.46	$194.38	$1,409.69
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.13 / $9.05 / $16.67	Facility	26	$7.13	$9.05	$16.67
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.41 / $46.54 / $79.77	Facility	TC	$23.41	$46.54	$79.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.44 / $36.67 / $113.75	Professional		$27.44	$36.67	$113.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.63 / $14.97 / $54.63	Professional	26	$7.63	$14.97	$54.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.00 / $39.40 / $83.83	Professional	TC	$22.00	$39.40	$83.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.75 / $19.75 / $37.95	Professional		$19.75	$19.75	$37.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.46 / $10.46 / $13.00	Professional	26	$10.46	$10.46	$13.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.78 / $49.87 / $164.48	Professional		$24.78	$49.87	$164.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.90 / $14.51 / $34.18	Professional	26	$4.90	$14.51	$34.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $35.93 / $100.85	Professional	TC	$20.42	$35.93	$100.85
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $6.76 / $16.14 / $41.91	Facility		$6.76	$16.14	$41.91
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $16.14 / $29.58 / $58.06	Professional		$16.14	$29.58	$58.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.04 / $75.95 / $94.66	Facility		$63.04	$75.95	$94.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.96 / $16.96 / $16.96	Facility	26	$16.96	$16.96	$16.96
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $77.70 / $77.70 / $77.70	Facility	TC	$77.70	$77.70	$77.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.17 / $49.70 / $128.57	Professional		$25.17	$49.70	$128.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.02 / $13.55 / $31.51	Professional	26	$6.02	$13.55	$31.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.39 / $37.65 / $98.35	Professional	TC	$18.39	$37.65	$98.35
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $6.50 / $6.50 / $6.50	Facility		$6.50	$6.50	$6.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $27.06 / $41.26 / $83.11	Professional		$27.06	$41.26	$83.11
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.00 / $12.48 / $36.00	Professional	26	$8.00	$12.48	$36.00
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.26 / $30.79 / $55.27	Professional	TC	$20.26	$30.79	$55.27
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.83 / $58.13 / $90.36	Professional		$34.83	$58.13	$90.36
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.24 / $15.45 / $29.47	Professional	26	$9.24	$15.45	$29.47
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.72 / $42.92 / $66.70	Professional	TC	$25.72	$42.92	$66.70
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $25.58 / $26.86	Professional		$10.23	$25.58	$26.86
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $12.16 / $15.50	Professional	26	$10.23	$12.16	$15.50
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.67 / $72.23 / $76.06	Professional		$48.67	$72.23	$76.06
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.55 / $17.32 / $27.20	Professional	26	$11.55	$17.32	$27.20
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $75.95 / $75.95 / $94.66	Facility		$75.95	$75.95	$94.66
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $16.96 / $16.96 / $16.96	Facility	26	$16.96	$16.96	$16.96
MVP Health Care Facility/Professional Facility Modifier TC Low / Median / High Price $77.70 / $77.70 / $77.70	Facility	TC	$77.70	$77.70	$77.70
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $25.17 / $41.83 / $130.49	Professional		$25.17	$41.83	$130.49
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $6.02 / $11.62 / $25.38	Professional	26	$6.02	$11.62	$25.38
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $18.39 / $32.52 / $96.22	Professional	TC	$18.39	$32.52	$96.22
United Facility/Professional Professional Modifier Low / Median / High Price $22.17 / $30.21 / $76.31	Professional		$22.17	$30.21	$76.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $8.00 / $20.58	Professional	26	$5.75	$8.00	$20.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.47 / $23.15 / $55.46	Professional	TC	$16.47	$23.15	$55.46
Univera Facility/Professional Professional Modifier Low / Median / High Price $39.51 / $58.13 / $108.90	Professional		$39.51	$58.13	$108.90
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $10.42 / $15.79 / $29.47	Professional	26	$10.42	$15.79	$29.47
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $29.09 / $42.92 / $80.40	Professional	TC	$29.09	$42.92	$80.40