Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.83 / $9.80 / $16.05	Facility	26	$7.83	$9.80	$16.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.67 / $63.39 / $158.40	Professional		$48.67	$63.39	$158.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.64 / $9.49 / $23.30	Professional	26	$7.64	$9.49	$23.30
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $24.34 / $29.13 / $41.36	Professional	52	$24.34	$29.13	$41.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.84 / $50.39 / $86.58	Professional	TC	$40.84	$50.39	$86.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.13 / $52.59 / $84.67	Professional		$47.13	$52.59	$84.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.55 / $9.61 / $16.48	Professional	26	$7.55	$9.61	$16.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $39.45 / $39.45 / $39.45	Professional	TC	$39.45	$39.45	$39.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.43 / $60.50 / $109.13	Professional		$51.43	$60.50	$109.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.28 / $8.75 / $16.34	Professional	26	$7.28	$8.75	$16.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.14 / $51.93 / $90.74	Professional	TC	$44.14	$51.93	$90.74
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $12.74 / $70.08 / $82.82	Professional		$12.74	$70.08	$82.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.06 / $10.06 / $10.06	Facility	26	$10.06	$10.06	$10.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.97 / $82.72 / $182.74	Professional		$58.97	$82.72	$182.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.49 / $27.36	Professional	26	$8.91	$12.49	$27.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.89 / $70.64 / $151.26	Professional	TC	$49.89	$70.64	$151.26
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $59.84 / $77.79 / $118.66	Professional		$59.84	$77.79	$118.66
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.99 / $11.58 / $17.84	Professional	26	$8.99	$11.58	$17.84
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.09 / $66.42 / $101.29	Professional	TC	$53.09	$66.42	$101.29
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $8.22 / $8.22 / $8.22	Facility	26	$8.22	$8.22	$8.22
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.74 / $58.94 / $113.03	Professional		$42.74	$58.94	$113.03
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.73 / $9.44 / $18.66	Professional	26	$6.73	$9.44	$18.66
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.02 / $49.57 / $95.28	Professional	TC	$36.02	$49.57	$95.28
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $55.11 / $55.11 / $55.46	Professional		$55.11	$55.11	$55.46
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $7.14 / $8.40 / $9.89	Professional	26	$7.14	$8.40	$9.89
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.06 / $72.70 / $132.35	Professional		$61.06	$72.70	$132.35
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $11.24 / $17.71	Professional	26	$9.69	$11.24	$17.71
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $10.06 / $10.06 / $10.06	Facility	26	$10.06	$10.06	$10.06
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $55.90 / $76.94 / $165.81	Professional		$55.90	$76.94	$165.81
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $12.12 / $24.61	Professional	26	$9.11	$12.12	$24.61
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $49.01 / $64.43 / $137.19	Professional	TC	$49.01	$64.43	$137.19
United Facility/Professional Professional Modifier Low / Median / High Price $48.47 / $63.42 / $125.70	Professional		$48.47	$63.42	$125.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.48 / $10.08 / $21.04	Professional	26	$7.48	$10.08	$21.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.97 / $54.56 / $106.56	Professional	TC	$40.97	$54.56	$106.56
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $8.22 / $10.92 / $17.10	Facility	26	$8.22	$10.92	$17.10
Univera Facility/Professional Professional Modifier Low / Median / High Price $46.21 / $70.04 / $142.37	Professional		$46.21	$70.04	$142.37
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $7.19 / $11.00 / $22.36	Professional	26	$7.19	$11.00	$22.36
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $39.47 / $59.04 / $120.01	Professional	TC	$39.47	$59.04	$120.01