Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.04 / $250.87 / $679.36	Facility		$36.04	$250.87	$679.36
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.34 / $19.50 / $61.35	Facility	26	$10.34	$19.50	$61.35
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.86 / $175.23 / $659.92	Facility	TC	$32.86	$175.23	$659.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.64 / $43.16 / $120.53	Professional		$24.64	$43.16	$120.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.15 / $10.15 / $42.00	Professional	26	$8.15	$10.15	$42.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.27 / $71.06 / $113.04	Professional	50	$19.27	$71.06	$113.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $26.43 / $79.56	Professional	TC	$19.14	$26.43	$79.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.37 / $28.96 / $36.78	Professional		$21.37	$28.96	$36.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.86 / $8.61 / $12.07	Professional	26	$6.86	$8.61	$12.07
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $32.04 / $32.04 / $38.52	Professional	50	$32.04	$32.04	$38.52
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $24.24 / $24.24	Professional	TC	$18.82	$24.24	$24.24
BCBS Facility/Professional Facility Modifier Low / Median / High Price $19.52 / $69.67 / $116.09	Facility		$19.52	$69.67	$116.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.44 / $30.22 / $38.34	Professional		$26.44	$30.22	$38.34
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.27 / $7.17 / $10.06	Professional	26	$6.27	$7.17	$10.06
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.17 / $23.05 / $28.81	Professional	TC	$20.17	$23.05	$28.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.62 / $189.46 / $247.64	Facility		$58.62	$189.46	$247.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.06 / $37.70 / $63.01	Professional		$27.06	$37.70	$63.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.65 / $10.85 / $19.73	Professional	26	$7.65	$10.85	$19.73
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $39.20 / $39.20 / $39.20	Professional	50	$39.20	$39.20	$39.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.12 / $25.81 / $42.40	Professional	TC	$19.12	$25.81	$42.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $32.46 / $40.50 / $286.83	Facility		$32.46	$40.50	$286.83
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $116.58 / $116.58 / $116.58	Facility	TC	$116.58	$116.58	$116.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.00 / $33.64 / $221.82	Professional		$29.00	$33.64	$221.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.72 / $9.96 / $89.16	Professional	26	$8.72	$9.96	$89.16
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.73 / $24.31 / $177.00	Professional	TC	$19.73	$24.31	$177.00
United Facility/Professional Professional Modifier Low / Median / High Price $29.00 / $33.56 / $53.70	Professional		$29.00	$33.56	$53.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.59 / $9.86 / $17.86	Professional	26	$8.59	$9.86	$17.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $23.82 / $42.91	Professional	TC	$19.32	$23.82	$42.91