Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $10.47 / $20.89	Facility	26	$7.76	$10.47	$20.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $69.18 / $199.53	Professional		$51.29	$69.18	$199.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.72 / $31.62	Professional	26	$7.94	$10.72	$31.62
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $8.13 / $8.32 / $39.81	Professional	52	$8.13	$8.32	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $53.70 / $120.23	Professional	TC	$42.66	$53.70	$120.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $56.23 / $66.07	Professional		$50.12	$56.23	$66.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $8.32 / $14.45	Professional	26	$7.59	$8.32	$14.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $67.61 / $67.61	Professional	TC	$67.61	$67.61	$67.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $60.26 / $104.71	Professional		$51.29	$60.26	$104.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $8.51 / $15.85	Professional	26	$7.24	$8.51	$15.85
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $52.48 / $87.10	Professional	TC	$43.65	$52.48	$87.10
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $70.79 / $83.18	Professional		$12.88	$70.79	$83.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.14 / $10.00 / $14.13	Facility	26	$2.14	$10.00	$14.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $81.28 / $194.98	Professional		$58.88	$81.28	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.59 / $28.84	Professional	26	$8.91	$12.59	$28.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $69.18 / $165.96	Professional	TC	$48.98	$69.18	$165.96
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $91.20 / $131.83	Professional		$74.13	$91.20	$131.83
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $13.18 / $19.95	Professional	26	$10.47	$13.18	$19.95
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $83.18 / $112.20	Professional	TC	$63.10	$83.18	$112.20
Excellus BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $8.13 / $8.13	Facility	26	$8.13	$8.13	$8.13
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $69.18 / $117.49	Professional		$38.90	$69.18	$117.49
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $10.96 / $18.62	Professional	26	$6.76	$10.96	$18.62
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $58.88 / $100.00	Professional	TC	$33.11	$58.88	$100.00
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $7.08 / $10.00	Professional	26	$7.08	$7.08	$10.00
Fidelis Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $79.43 / $79.43	Professional	TC	$79.43	$79.43	$79.43
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $72.44 / $97.72	Professional		$58.88	$72.44	$97.72
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $11.22 / $14.79	Professional	26	$10.72	$11.22	$14.79
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $77.62 / $147.91	Professional		$64.57	$77.62	$147.91
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.88 / $23.44	Professional	26	$10.47	$12.88	$23.44
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $64.57 / $125.89	Professional	TC	$53.70	$64.57	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $63.10 / $125.89	Professional		$47.86	$63.10	$125.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $10.00 / $19.95	Professional	26	$7.24	$10.00	$19.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $53.70 / $107.15	Professional	TC	$40.74	$53.70	$107.15
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $5.89 / $10.96 / $16.98	Facility	26	$5.89	$10.96	$16.98
Univera Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $69.18 / $123.03	Professional		$45.71	$69.18	$123.03
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $10.96 / $20.89	Professional	26	$6.76	$10.96	$20.89
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $58.88 / $104.71	Professional	TC	$38.90	$58.88	$104.71