Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.41 / $211.70 / $631.54	Facility		$28.41	$211.70	$631.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.41 / $12.62 / $18.14	Facility	26	$8.41	$12.62	$18.14
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.18 / $214.23 / $379.86	Facility	TC	$17.18	$214.23	$379.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.14 / $25.06 / $104.00	Professional		$19.14	$25.06	$104.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.66 / $9.31 / $34.93	Professional	26	$7.66	$9.31	$34.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.66 / $16.27 / $35.06	Professional	TC	$10.66	$16.27	$35.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.54 / $18.54 / $18.54	Professional		$18.54	$18.54	$18.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.44 / $9.09 / $13.02	Professional	26	$6.44	$9.09	$13.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $12.55 / $12.55 / $12.55	Professional	TC	$12.55	$12.55	$12.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.75 / $27.97 / $42.94	Professional		$22.75	$27.97	$42.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.02 / $11.14 / $16.92	Professional	26	$9.02	$11.14	$16.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.73 / $16.88 / $27.88	Professional	TC	$13.73	$16.88	$27.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.48 / $59.44 / $199.12	Facility		$30.48	$59.44	$199.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $19.39 / $19.39 / $19.39	Facility	TC	$19.39	$19.39	$19.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.54 / $28.45 / $50.02	Professional		$18.54	$28.45	$50.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.37 / $12.41 / $20.30	Professional	26	$7.37	$12.41	$20.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.30 / $16.47 / $30.47	Professional	TC	$10.30	$16.47	$30.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $22.60 / $37.93 / $233.42	Facility		$22.60	$37.93	$233.42
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $20.47 / $70.00 / $70.00	Facility	26	$20.47	$70.00	$70.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $36.54 / $78.72 / $78.72	Facility	TC	$36.54	$78.72	$78.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.99 / $28.63 / $165.42	Professional		$20.99	$28.63	$165.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.07 / $12.17 / $55.28	Professional	26	$9.07	$12.17	$55.28
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $11.26 / $18.11 / $110.07	Professional	TC	$11.26	$18.11	$110.07
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $44.36 / $44.36 / $44.36	Professional		$44.36	$44.36	$44.36
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $15.79 / $15.79 / $15.79	Professional	26	$15.79	$15.79	$15.79
United Facility/Professional Facility Modifier Low / Median / High Price $62.11 / $112.55 / $185.87	Facility		$62.11	$112.55	$185.87
United Facility/Professional Professional Modifier Low / Median / High Price $20.56 / $28.24 / $51.07	Professional		$20.56	$28.24	$51.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.81 / $10.93 / $17.21	Professional	26	$8.81	$10.93	$17.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.85 / $17.27 / $30.82	Professional	TC	$10.85	$17.27	$30.82