Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.49 / $183.14 / $407.71	Facility		$42.49	$183.14	$407.71
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.02 / $14.00 / $22.19	Facility	26	$10.02	$14.00	$22.19
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.46 / $214.54 / $346.94	Facility	TC	$28.46	$214.54	$346.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.02 / $37.57 / $129.60	Professional		$27.02	$37.57	$129.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.14 / $13.05 / $43.00	Professional	26	$9.14	$13.05	$43.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.02 / $25.43 / $92.23	Professional	TC	$18.02	$25.43	$92.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.82 / $26.75 / $47.28	Professional		$19.82	$26.75	$47.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.72 / $10.84 / $15.53	Professional	26	$7.72	$10.84	$15.53
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.34 / $29.24 / $33.84	Professional	TC	$21.34	$29.24	$33.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.86 / $37.54 / $57.26	Professional		$28.86	$37.54	$57.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.77 / $14.03 / $20.77	Professional	26	$10.77	$14.03	$20.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.00 / $22.89 / $37.53	Professional	TC	$18.00	$22.89	$37.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.15 / $80.01 / $199.12	Facility		$40.15	$80.01	$199.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $11.95	Facility	26	$11.95	$11.95	$11.95
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.10 / $26.10 / $26.10	Facility	TC	$26.10	$26.10	$26.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.28 / $41.20 / $68.51	Professional		$25.28	$41.20	$68.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.06 / $14.81 / $24.27	Professional	26	$9.06	$14.81	$24.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.95 / $26.19 / $45.76	Professional	TC	$16.95	$26.19	$45.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.72 / $55.38 / $296.00	Facility		$30.72	$55.38	$296.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $24.59 / $70.00 / $70.00	Facility	26	$24.59	$70.00	$70.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $40.13 / $105.96 / $105.96	Facility	TC	$40.13	$105.96	$105.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.70 / $39.84 / $215.20	Professional		$29.70	$39.84	$215.20
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.90 / $15.02 / $66.04	Professional	26	$10.90	$15.02	$66.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $18.80 / $25.26 / $149.15	Professional	TC	$18.80	$25.26	$149.15
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $57.44 / $57.44 / $57.44	Professional		$57.44	$57.44	$57.44
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $18.92 / $18.92 / $18.92	Professional	26	$18.92	$18.92	$18.92
United Facility/Professional Professional Modifier Low / Median / High Price $29.70 / $37.10 / $62.47	Professional		$29.70	$37.10	$62.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.53 / $13.39 / $22.38	Professional	26	$10.53	$13.39	$22.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.80 / $24.12 / $42.83	Professional	TC	$18.80	$24.12	$42.83