Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.86 / $185.37 / $399.61	Facility		$41.86	$185.37	$399.61
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.35 / $12.25 / $19.94	Facility	26	$10.35	$12.25	$19.94
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.05 / $185.37 / $433.56	Facility	TC	$28.05	$185.37	$433.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.43 / $47.42 / $161.13	Professional		$34.43	$47.42	$161.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.90 / $15.35 / $50.00	Professional	26	$9.90	$15.35	$50.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.65 / $31.03 / $98.67	Professional	TC	$24.65	$31.03	$98.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.18 / $31.46 / $59.07	Professional		$24.18	$31.46	$59.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $11.92 / $16.93	Professional	26	$7.95	$11.92	$16.93
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.52 / $41.68 / $42.05	Professional	TC	$26.52	$41.68	$42.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.21 / $43.02 / $71.88	Professional		$33.21	$43.02	$71.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.09 / $14.60 / $22.79	Professional	26	$11.09	$14.60	$22.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.13 / $29.65 / $49.09	Professional	TC	$22.13	$29.65	$49.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.68 / $100.35 / $247.79	Facility		$68.68	$100.35	$247.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $32.44 / $32.44 / $32.44	Facility	TC	$32.44	$32.44	$32.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.09 / $48.84 / $77.39	Professional		$30.09	$48.84	$77.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $15.27 / $23.57	Professional	26	$9.36	$15.27	$23.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.14 / $34.07 / $56.72	Professional	TC	$21.14	$34.07	$56.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.15 / $54.31 / $182.03	Facility		$36.15	$54.31	$182.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $25.22 / $100.00 / $100.00	Facility	26	$25.22	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $61.48 / $131.69 / $131.69	Facility	TC	$61.48	$131.69	$131.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.38 / $50.67 / $254.22	Professional		$35.38	$50.67	$254.22
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.97 / $15.50 / $90.81	Professional	26	$10.97	$15.50	$90.81
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.57 / $35.20 / $195.00	Professional	TC	$23.57	$35.20	$195.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $19.47 / $19.47 / $19.47	Professional	26	$19.47	$19.47	$19.47
United Facility/Professional Facility Modifier Low / Median / High Price $44.29 / $112.55 / $185.87	Facility		$44.29	$112.55	$185.87
United Facility/Professional Professional Modifier Low / Median / High Price $34.36 / $42.70 / $72.78	Professional		$34.36	$42.70	$72.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $13.43 / $21.16	Professional	26	$10.83	$13.43	$21.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.14 / $30.26 / $50.13	Professional	TC	$23.14	$30.26	$50.13