Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.04 / $239.55 / $455.22	Facility		$44.04	$239.55	$455.22
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.35 / $12.45 / $19.94	Facility	26	$10.35	$12.45	$19.94
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.05 / $259.89 / $388.96	Facility	TC	$29.05	$259.89	$388.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.72 / $46.83 / $159.00	Professional		$34.72	$46.83	$159.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.61 / $15.06 / $48.45	Professional	26	$9.61	$15.06	$48.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.79 / $32.01 / $83.84	Professional	TC	$24.79	$32.01	$83.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.18 / $31.41 / $58.61	Professional		$24.18	$31.41	$58.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $11.18 / $16.02	Professional	26	$7.95	$11.18	$16.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.52 / $35.74 / $42.05	Professional	TC	$26.52	$35.74	$42.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.21 / $41.04 / $75.37	Professional		$33.21	$41.04	$75.37
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 / $28.02 / $52.56	Professional	TC	$22.13	$28.02	$52.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.92 / $108.45 / $455.25	Facility		$72.92	$108.45	$455.25
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 $32.79 / $32.79 / $32.79	Facility	TC	$32.79	$32.79	$32.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.70 / $49.36 / $78.04	Professional		$30.70	$49.36	$78.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $15.40 / $23.57	Professional	26	$9.36	$15.40	$23.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.58 / $35.40 / $56.85	Professional	TC	$21.58	$35.40	$56.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.46 / $56.53 / $300.25	Facility		$36.46	$56.53	$300.25
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 $36.51 / $50.90 / $256.38	Professional		$36.51	$50.90	$256.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.00 / $15.48 / $82.56	Professional	26	$11.00	$15.48	$82.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.24 / $35.20 / $211.00	Professional	TC	$25.24	$35.20	$211.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $67.40 / $67.40 / $67.40	Professional		$67.40	$67.40	$67.40
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 Professional Modifier Low / Median / High Price $34.76 / $43.05 / $74.09	Professional		$34.76	$43.05	$74.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $13.09 / $21.65	Professional	26	$10.83	$13.09	$21.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.05 / $30.35 / $50.13	Professional	TC	$24.05	$30.35	$50.13