Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.64 / $3.74 / $7.01	Facility	26	$2.64	$3.74	$7.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.68 / $38.93 / $129.86	Professional		$22.68	$38.93	$129.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.83 / $4.05 / $14.99	Professional	26	$2.83	$4.05	$14.99
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.33 / $14.03 / $32.04	Professional	52	$11.33	$14.03	$32.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.01 / $33.19 / $82.00	Professional	TC	$20.01	$33.19	$82.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.22 / $40.72 / $40.72	Professional		$27.22	$40.72	$40.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.40 / $5.40 / $6.85	Professional	26	$5.40	$5.40	$6.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.75 / $29.46 / $88.69	Professional		$22.75	$29.46	$88.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $2.59 / $3.39 / $8.52	Professional	26	$2.59	$3.39	$8.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.16 / $25.57 / $69.11	Professional	TC	$20.16	$25.57	$69.11
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $4.45 / $30.56 / $35.01	Professional		$4.45	$30.56	$35.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.49 / $3.49 / $3.49	Facility	26	$3.49	$3.49	$3.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.88 / $53.25 / $231.70	Professional		$24.88	$53.25	$231.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.95 / $5.40 / $10.38	Professional	26	$2.95	$5.40	$10.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.38 / $51.65 / $166.64	Professional	TC	$22.38	$51.65	$166.64
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $26.69 / $59.78 / $74.80	Professional		$26.69	$59.78	$74.80
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.11 / $4.18 / $8.74	Professional	26	$3.11	$4.18	$8.74
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.64 / $27.94 / $56.33	Professional	TC	$22.64	$27.94	$56.33
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.89 / $33.13 / $49.02	Professional		$18.89	$33.13	$49.02
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $2.85 / $4.26 / $6.53	Professional	26	$2.85	$4.26	$6.53
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.38 / $29.52 / $42.49	Professional	TC	$16.38	$29.52	$42.49
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $22.09 / $22.09 / $24.79	Professional		$22.09	$22.09	$24.79
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $2.86 / $3.11 / $3.74	Professional	26	$2.86	$3.11	$3.74
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.13 / $32.13 / $48.59	Professional		$32.13	$32.13	$48.59
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.13 / $4.13 / $6.46	Professional	26	$4.13	$4.13	$6.46
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.99 / $27.99 / $28.15	Professional	TC	$27.99	$27.99	$28.15
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $3.49 / $3.49 / $3.49	Facility	26	$3.49	$3.49	$3.49
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $25.31 / $48.45 / $185.55	Professional		$25.31	$48.45	$185.55
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $3.21 / $4.72 / $9.83	Professional	26	$3.21	$4.72	$9.83
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $22.11 / $32.08 / $145.49	Professional	TC	$22.11	$32.08	$145.49
United Facility/Professional Professional Modifier Low / Median / High Price $24.17 / $32.63 / $124.47	Professional		$24.17	$32.63	$124.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.65 / $3.79 / $7.69	Professional	26	$2.65	$3.79	$7.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.96 / $28.14 / $91.17	Professional	TC	$20.96	$28.14	$91.17
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $4.26 / $4.26 / $15.00	Facility	26	$4.26	$4.26	$15.00
Univera Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $34.06 / $71.23	Professional		$25.12	$34.06	$71.23
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $3.35 / $4.48 / $9.49	Professional	26	$3.35	$4.48	$9.49
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $21.77 / $29.52 / $61.74	Professional	TC	$21.77	$29.52	$61.74