Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.15 / $164.63 / $350.73	Facility		$35.15	$164.63	$350.73
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.39 / $13.31 / $22.20	Facility	26	$9.39	$13.31	$22.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.14 / $229.73 / $373.60	Facility	TC	$23.14	$229.73	$373.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.66 / $36.89 / $140.99	Professional		$28.66	$36.89	$140.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.53 / $13.67 / $49.00	Professional	26	$8.53	$13.67	$49.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.37 / $23.98 / $61.00	Professional	TC	$19.37	$23.98	$61.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.85 / $28.26 / $49.30	Professional		$18.85	$28.26	$49.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.21 / $10.14 / $15.33	Professional	26	$7.21	$10.14	$15.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.23 / $30.23 / $30.23	Professional	TC	$30.23	$30.23	$30.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.04 / $38.17 / $66.31	Professional		$31.04	$38.17	$66.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.09 / $13.69 / $22.62	Professional	26	$11.09	$13.69	$22.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $25.26 / $43.53	Professional	TC	$19.95	$25.26	$43.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.67 / $87.25 / $455.25	Facility		$57.67	$87.25	$455.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.16 / $11.16 / $11.16	Facility	26	$11.16	$11.16	$11.16
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 $25.49 / $44.36 / $69.65	Professional		$25.49	$44.36	$69.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.68 / $14.35 / $22.08	Professional	26	$8.68	$14.35	$22.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.36 / $29.95 / $46.22	Professional	TC	$18.36	$29.95	$46.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.23 / $46.94 / $109.42	Facility		$29.23	$46.94	$109.42
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $22.84 / $100.00 / $100.00	Facility	26	$22.84	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $49.38 / $105.96 / $105.96	Facility	TC	$49.38	$105.96	$105.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.12 / $43.36 / $218.00	Professional		$31.12	$43.36	$218.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $14.13 / $87.52	Professional	26	$10.11	$14.13	$87.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.56 / $28.98 / $206.00	Professional	TC	$20.56	$28.98	$206.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $56.15 / $56.15 / $56.15	Professional		$56.15	$56.15	$56.15
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $17.63 / $17.63 / $17.63	Professional	26	$17.63	$17.63	$17.63
United Facility/Professional Professional Modifier Low / Median / High Price $28.91 / $36.56 / $61.20	Professional		$28.91	$36.56	$61.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.94 / $12.28 / $19.70	Professional	26	$9.94	$12.28	$19.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $25.19 / $42.55	Professional	TC	$19.76	$25.19	$42.55