Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.60 / $59.60 / $59.60	Facility		$59.60	$59.60	$59.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.50 / $28.50 / $28.50	Facility	26	$28.50	$28.50	$28.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $35.82 / $54.31	Professional		$27.54	$35.82	$54.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.71 / $15.61 / $21.61	Professional	26	$12.71	$15.61	$21.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.77 / $18.54 / $35.28	Professional	TC	$13.77	$18.54	$35.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.88 / $35.88 / $35.88	Professional		$35.88	$35.88	$35.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.77 / $28.75 / $88.55	Professional		$22.77	$28.75	$88.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.92 / $13.79 / $37.01	Professional	26	$10.92	$13.79	$37.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $11.84 / $14.96 / $48.26	Professional	TC	$11.84	$14.96	$48.26
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $22.54 / $22.54 / $24.73	Facility		$22.54	$22.54	$24.73
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $22.54 / $24.73 / $47.26	Professional		$22.54	$24.73	$47.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.28 / $37.28 / $37.28	Facility		$37.28	$37.28	$37.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.95 / $17.95 / $17.95	Facility	26	$17.95	$17.95	$17.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.73 / $50.57 / $118.00	Professional		$22.73	$50.57	$118.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.29 / $20.70 / $53.00	Professional	26	$10.29	$20.70	$53.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.31 / $27.95 / $70.75	Professional	TC	$12.31	$27.95	$70.75
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $26.36 / $40.60 / $67.38	Professional		$26.36	$40.60	$67.38
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.75 / $21.53 / $39.45	Professional	26	$17.75	$21.53	$39.45
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.91 / $23.49 / $35.97	Professional	TC	$20.91	$23.49	$35.97
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.05 / $31.05 / $31.05	Facility		$31.05	$31.05	$31.05
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $14.85 / $14.85 / $14.85	Facility	26	$14.85	$14.85	$14.85
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.16 / $39.06 / $57.94	Professional		$27.16	$39.06	$57.94
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.99 / $14.85 / $27.71	Professional	26	$12.99	$14.85	$27.71
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.17 / $22.68 / $30.23	Professional	TC	$14.17	$22.68	$30.23
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.40 / $39.74 / $40.18	Professional		$39.40	$39.74	$40.18
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $37.28 / $555.00 / $597.00	Facility		$37.28	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $17.95 / $17.95 / $17.95	Facility	26	$17.95	$17.95	$17.95
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $25.17 / $45.60 / $114.65	Professional		$25.17	$45.60	$114.65
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $10.93 / $20.17 / $50.97	Professional	26	$10.93	$20.17	$50.97
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $12.52 / $23.01 / $61.77	Professional	TC	$12.52	$23.01	$61.77
United Facility/Professional Professional Modifier Low / Median / High Price $22.07 / $32.15 / $69.56	Professional		$22.07	$32.15	$69.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.10 / $14.27 / $31.63	Professional	26	$10.10	$14.27	$31.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.60 / $17.01 / $38.08	Professional	TC	$11.60	$17.01	$38.08
Univera Facility/Professional Facility Modifier Low / Median / High Price $31.05 / $31.05 / $31.05	Facility		$31.05	$31.05	$31.05
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $14.85 / $14.85 / $14.85	Facility	26	$14.85	$14.85	$14.85
Univera Facility/Professional Professional Modifier Low / Median / High Price $27.16 / $39.06 / $61.19	Professional		$27.16	$39.06	$61.19
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $12.99 / $14.94 / $29.27	Professional	26	$12.99	$14.94	$29.27
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $14.17 / $21.53 / $31.92	Professional	TC	$14.17	$21.53	$31.92