Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $123.03 / $407.38	Facility		$37.15	$123.03	$407.38
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $13.80 / $32.36	Facility	26	$10.00	$13.80	$32.36
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.88 / $69.18 / $354.81	Facility	TC	$21.88	$69.18	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $44.67 / $138.04	Professional		$27.54	$44.67	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $13.18 / $43.65	Professional	26	$8.91	$13.18	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $29.51 / $85.11	Professional	TC	$18.62	$29.51	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $26.30 / $48.98	Professional		$20.89	$26.30	$48.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.23 / $16.22	Professional	26	$7.76	$10.23	$16.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $19.50 / $29.51	Professional	TC	$14.13	$19.50	$29.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $35.48 / $58.88	Professional		$28.84	$35.48	$58.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $13.49 / $21.38	Professional	26	$10.72	$13.49	$21.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $22.91 / $39.81	Professional	TC	$18.20	$22.91	$39.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $28.18 / $50.12	Facility		$26.30	$28.18	$50.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $36.31 / $46.77	Professional		$34.67	$36.31	$46.77
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $11.22 / $16.98	Professional	26	$10.96	$11.22	$16.98
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $25.12 / $32.36	Professional	TC	$22.91	$25.12	$32.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $74.13 / $199.53	Facility		$39.81	$74.13	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $39.81 / $72.44	Professional		$26.30	$39.81	$72.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $14.45 / $26.92	Professional	26	$9.12	$14.45	$26.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $26.30 / $50.12	Professional	TC	$16.98	$26.30	$50.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $61.66 / $331.13	Facility		$29.51	$61.66	$331.13
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $70.79 / $70.79	Facility	26	$24.55	$70.79	$70.79
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $48.98 / $107.15 / $107.15	Facility	TC	$48.98	$107.15	$107.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $39.81 / $213.80	Professional		$28.18	$39.81	$213.80
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.22 / $66.07	Professional	26	$10.96	$16.22	$66.07
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $25.70 / $147.91	Professional	TC	$18.62	$25.70	$147.91
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $57.54 / $57.54	Professional		$48.98	$57.54	$57.54
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $19.05 / $19.05	Professional	26	$16.22	$19.05	$19.05
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $33.11 / $38.90	Professional	TC	$33.11	$33.11	$38.90
United Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $72.44 / $112.20	Facility		$30.20	$72.44	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $35.48 / $57.54	Professional		$28.18	$35.48	$57.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.59 / $20.42	Professional	26	$10.00	$12.59	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $22.91 / $38.02	Professional	TC	$18.62	$22.91	$38.02