Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $12.34 / $23.13	Facility	26	$10.80	$12.34	$23.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.94 / $62.60 / $172.55	Professional		$37.94	$62.60	$172.55
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $13.76 / $13.86 / $125.25	Professional	25	$13.76	$13.86	$125.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.84 / $13.76 / $39.86	Professional	26	$9.84	$13.76	$39.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.26 / $45.65 / $72.20	Professional	TC	$27.26	$45.65	$72.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.07 / $36.86 / $63.89	Professional		$33.07	$36.86	$63.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.84 / $11.09 / $19.02	Professional	26	$8.84	$11.09	$19.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.23 / $24.23 / $26.36	Professional	TC	$24.23	$24.23	$26.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.02 / $44.48 / $114.02	Professional		$34.02	$44.48	$114.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $10.59 / $23.80	Professional	26	$8.34	$10.59	$23.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.68 / $32.47 / $83.77	Professional	TC	$25.68	$32.47	$83.77
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $14.72 / $50.03 / $64.75	Professional		$14.72	$50.03	$64.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.60 / $11.60 / $11.60	Facility	26	$11.60	$11.60	$11.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.22 / $79.39 / $168.33	Professional		$46.22	$79.39	$168.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.23 / $18.32 / $36.29	Professional	26	$11.23	$18.32	$36.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.93 / $61.45 / $130.30	Professional	TC	$34.93	$61.45	$130.30
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $43.73 / $54.00 / $101.42	Professional		$43.73	$54.00	$101.42
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.67 / $13.47 / $23.13	Professional	26	$10.67	$13.47	$23.13
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.50 / $40.79 / $78.80	Professional	TC	$32.50	$40.79	$78.80
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $9.50 / $9.50 / $9.50	Facility	26	$9.50	$9.50	$9.50
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.61 / $48.42 / $82.00	Professional		$31.61	$48.42	$82.00
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.15 / $11.94 / $21.56	Professional	26	$9.15	$11.94	$21.56
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.30 / $35.69 / $60.44	Professional	TC	$23.30	$35.69	$60.44
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $38.17 / $38.17 / $49.20	Professional		$38.17	$38.17	$49.20
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $9.68 / $9.68 / $11.39	Professional	26	$9.68	$9.68	$11.39
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.65 / $61.82 / $106.50	Professional		$42.65	$61.82	$106.50
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.99 / $14.05 / $24.54	Professional	26	$11.99	$14.05	$24.54
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $11.60 / $11.60 / $11.60	Facility	26	$11.60	$11.60	$11.60
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $48.99 / $79.17 / $159.27	Professional		$48.99	$79.17	$159.27
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $11.91 / $17.27 / $32.95	Professional	26	$11.91	$17.27	$32.95
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $36.74 / $60.72 / $116.66	Professional	TC	$36.74	$60.72	$116.66
United Facility/Professional Professional Modifier Low / Median / High Price $43.22 / $65.11 / $131.93	Professional		$43.22	$65.11	$131.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.01 / $14.39 / $30.17	Professional	26	$10.01	$14.39	$30.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.85 / $51.13 / $104.36	Professional	TC	$31.85	$51.13	$104.36
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $9.50 / $12.61 / $57.49	Facility	26	$9.50	$12.61	$57.49
Univera Facility/Professional Professional Modifier Low / Median / High Price $36.14 / $48.34 / $98.83	Professional		$36.14	$48.34	$98.83
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $9.50 / $12.63 / $25.98	Professional	26	$9.50	$12.63	$25.98
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $26.64 / $35.69 / $72.84	Professional	TC	$26.64	$35.69	$72.84