Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $173.78 / $467.74	Facility		$28.18	$173.78	$467.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $10.47 / $19.50	Facility	26	$8.13	$10.47	$19.50
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.62 / $27.54 / $257.04	Facility	TC	$18.62	$27.54	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $37.15 / $114.82	Professional		$21.38	$37.15	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.23 / $34.67	Professional	26	$7.08	$10.23	$34.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $22.91 / $56.23	Professional	TC	$15.14	$22.91	$56.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $23.44 / $43.65	Professional		$17.38	$23.44	$43.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $8.32 / $13.18	Professional	26	$6.31	$8.32	$13.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $19.50 / $28.84	Professional	TC	$13.80	$19.50	$28.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $35.48 / $52.48	Professional		$29.51	$35.48	$52.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.96 / $17.38	Professional	26	$8.71	$10.96	$17.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $23.44 / $33.88	Professional	TC	$19.50	$23.44	$33.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $27.54 / $51.29	Facility		$21.88	$27.54	$51.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $30.90 / $44.67	Professional		$29.51	$30.90	$44.67
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $9.77 / $14.13	Professional	26	$9.12	$9.77	$14.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $21.38 / $28.18	Professional	TC	$20.42	$21.38	$28.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $67.61 / $457.09	Facility		$44.67	$67.61	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $36.31 / $64.57	Professional		$22.39	$36.31	$64.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $11.75 / $21.38	Professional	26	$7.41	$11.75	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $25.70 / $46.77	Professional	TC	$14.79	$25.70	$46.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $39.81 / $173.78	Facility		$24.55	$39.81	$173.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $19.50 / $100.00 / $100.00	Facility	26	$19.50	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $41.69 / $100.00 / $100.00	Facility	TC	$41.69	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $38.90 / $177.83	Professional		$25.70	$38.90	$177.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $12.59 / $77.62	Professional	26	$8.51	$12.59	$77.62
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $26.92 / $162.18	Professional	TC	$17.38	$26.92	$162.18
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $41.69 / $48.98	Professional		$40.74	$41.69	$48.98
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $15.14 / $15.49	Professional	26	$15.14	$15.14	$15.49
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $32.36 / $33.11	Professional	TC	$28.18	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $87.10 / $181.97	Facility		$27.54	$87.10	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $31.62 / $52.48	Professional		$25.12	$31.62	$52.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $9.77 / $16.60	Professional	26	$8.13	$9.77	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $21.38 / $37.15	Professional	TC	$16.98	$21.38	$37.15