Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $84.53 / $391.47	Facility		$27.54	$84.53	$391.47
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.42 / $38.38 / $195.84	Facility	26	$26.42	$38.38	$195.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.11 / $78.68 / $155.72	Professional		$39.11	$78.68	$155.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.43 / $33.36 / $72.36	Professional	26	$26.43	$33.36	$72.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $56.53 / $209.18 / $334.86	Professional	50	$56.53	$209.18	$334.86
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $20.18 / $31.04 / $66.43	Professional	52	$20.18	$31.04	$66.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.73 / $52.92 / $89.04	Professional	TC	$16.73	$52.92	$89.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.68 / $84.68 / $84.68	Professional		$84.68	$84.68	$84.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.12 / $74.70 / $172.14	Professional		$60.12	$74.70	$172.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.32 / $41.87 / $66.86	Professional	26	$33.32	$41.87	$66.86
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $90.18 / $111.10 / $256.56	Professional	50	$90.18	$111.10	$256.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.56 / $31.81 / $112.36	Professional	TC	$24.56	$31.81	$112.36
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $33.79 / $33.79 / $43.13	Facility		$33.79	$33.79	$43.13
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $33.79 / $43.13 / $76.93	Professional		$33.79	$43.13	$76.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.57 / $52.57 / $52.57	Facility		$52.57	$52.57	$52.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.84 / $33.84 / $33.84	Facility	26	$33.84	$33.84	$33.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.58 / $108.36 / $212.53	Professional		$42.58	$108.36	$212.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.51 / $43.27 / $96.37	Professional	26	$21.51	$43.27	$96.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.24 / $64.30 / $121.10	Professional	TC	$15.24	$64.30	$121.10
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $20.66 / $53.00 / $332.00	Facility		$20.66	$53.00	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $52.83 / $64.34 / $95.55	Professional		$52.83	$64.34	$95.55
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.84 / $40.09 / $61.06	Professional	26	$30.84	$40.09	$61.06
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.86 / $24.90 / $37.32	Professional	TC	$19.86	$24.90	$37.32
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.22 / $22.22 / $22.22	Facility		$22.22	$22.22	$22.22
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.52 / $63.53 / $99.92	Professional		$38.52	$63.53	$99.92
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.67 / $37.40 / $63.86	Professional	26	$22.67	$37.40	$63.86
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.90 / $24.14 / $42.03	Professional	TC	$13.90	$24.14	$42.03
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $31.45 / $31.45 / $31.45	Professional	26	$31.45	$31.45	$31.45
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $435.72 / $438.58 / $476.23	Facility		$435.72	$438.58	$476.23
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $52.57 / $52.57 / $74,999.25	Facility		$52.57	$52.57	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $33.84 / $33.84 / $33.84	Facility	26	$33.84	$33.84	$33.84
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $55.39 / $96.58 / $210.57	Professional		$55.39	$96.58	$210.57
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $23.90 / $41.77 / $92.24	Professional	26	$23.90	$41.77	$92.24
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $51.97 / $113.33	Professional	TC	$20.89	$51.97	$113.33
United Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $67.03 / $150.34	Professional		$40.65	$67.03	$150.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.00 / $33.61 / $71.84	Professional	26	$20.00	$33.61	$71.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.86 / $33.74 / $87.51	Professional	TC	$19.86	$33.74	$87.51
Univera Facility/Professional Facility Modifier Low / Median / High Price $52.12 / $52.12 / $258.10	Facility		$52.12	$52.12	$258.10
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $33.31 / $33.31 / $91.70	Facility	26	$33.31	$33.31	$91.70
Univera Facility/Professional Professional Modifier Low / Median / High Price $44.03 / $63.53 / $120.42	Professional		$44.03	$63.53	$120.42
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $22.67 / $37.65 / $76.95	Professional	26	$22.67	$37.65	$76.95
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $15.89 / $22.96 / $43.46	Professional	TC	$15.89	$22.96	$43.46