Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.03 / $110.58 / $972.64	Facility		$63.03	$110.58	$972.64
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $53.42 / $102.66 / $177.16	Facility	TC	$53.42	$102.66	$177.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.52 / $78.09 / $180.31	Professional		$43.52	$78.09	$180.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.55 / $22.40 / $90.95	Professional	26	$7.55	$22.40	$90.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.13 / $68.56 / $157.33	Professional	TC	$36.13	$68.56	$157.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.18 / $72.18 / $73.19	Professional		$72.18	$72.18	$73.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.12 / $11.12 / $13.00	Professional	26	$11.12	$11.12	$13.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.80 / $81.86 / $223.71	Professional		$28.80	$81.86	$223.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.04 / $14.16 / $35.18	Professional	26	$5.04	$14.16	$35.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.76 / $69.08 / $170.90	Professional	TC	$23.76	$69.08	$170.90
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $7.18 / $17.14 / $94.91	Facility		$7.18	$17.14	$94.91
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $17.14 / $57.09 / $112.06	Professional		$17.14	$57.09	$112.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $132.22 / $141.47 / $170.45	Facility		$132.22	$141.47	$170.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.26 / $20.26 / $20.26	Facility	26	$20.26	$20.26	$20.26
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $111.96 / $111.96 / $111.96	Facility	TC	$111.96	$111.96	$111.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.78 / $81.15 / $210.54	Professional		$36.78	$81.15	$210.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.40 / $14.30 / $29.93	Professional	26	$6.40	$14.30	$29.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.85 / $71.04 / $178.23	Professional	TC	$33.85	$71.04	$178.23
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $7.50 / $7.50 / $7.50	Facility		$7.50	$7.50	$7.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $52.16 / $87.21 / $143.96	Professional		$52.16	$87.21	$143.96
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.48 / $12.11 / $21.03	Professional	26	$8.48	$12.11	$21.03
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.95 / $68.17 / $122.93	Professional	TC	$44.95	$68.17	$122.93
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.45 / $89.55 / $174.02	Professional		$28.45	$89.55	$174.02
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.68 / $12.93 / $25.12	Professional	26	$9.68	$12.93	$25.12
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.07 / $76.62 / $148.91	Professional	TC	$17.07	$76.62	$148.91
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $3.99 / $8.38 / $83.08	Professional		$3.99	$8.38	$83.08
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $3.99 / $10.52 / $15.10	Professional	26	$3.99	$10.52	$15.10
Fidelis Facility/Professional Professional Modifier TC Low / Median / High Price $3.99 / $9.48 / $10.48	Professional	TC	$3.99	$9.48	$10.48
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.77 / $84.45 / $136.62	Professional		$75.77	$84.45	$136.62
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.15 / $22.22 / $49.61	Professional	26	$12.15	$22.22	$49.61
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $132.22 / $132.22 / $170.45	Facility		$132.22	$132.22	$170.45
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $20.26 / $20.26 / $20.26	Facility	26	$20.26	$20.26	$20.26
MVP Health Care Facility/Professional Facility Modifier TC Low / Median / High Price $111.96 / $111.96 / $111.96	Facility	TC	$111.96	$111.96	$111.96
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $13.73 / $79.56 / $206.15	Professional		$13.73	$79.56	$206.15
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $12.34 / $25.70	Professional	26	$6.46	$12.34	$25.70
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $33.85 / $68.25 / $157.21	Professional	TC	$33.85	$68.25	$157.21
United Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $54.62 / $141.19	Professional		$38.00	$54.62	$141.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.67 / $8.15 / $21.67	Professional	26	$5.67	$8.15	$21.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.38 / $47.32 / $116.06	Professional	TC	$35.38	$47.32	$116.06
Univera Facility/Professional Professional Modifier Low / Median / High Price $28.45 / $89.55 / $209.73	Professional		$28.45	$89.55	$209.73
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $12.93 / $30.27	Professional	26	$11.07	$12.93	$30.27
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $17.23 / $76.62 / $179.45	Professional	TC	$17.23	$76.62	$179.45