Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $263.03 / $691.83	Facility		$38.02	$263.03	$691.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $32.36 / $83.18	Facility	26	$10.23	$32.36	$83.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.11 / $64.57 / $263.03	Facility	TC	$33.11	$64.57	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $39.81 / $112.20	Professional		$9.55	$39.81	$112.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $13.18 / $48.98	Professional	26	$8.13	$13.18	$48.98
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $34.67 / $79.43 / $199.53	Professional	50	$34.67	$79.43	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $36.31 / $85.11	Professional	TC	$19.95	$36.31	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $28.84 / $51.29	Professional		$22.39	$28.84	$51.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $8.32 / $13.80	Professional	26	$6.61	$8.32	$13.80
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.90 / $47.86 / $83.18	Professional	50	$38.90	$47.86	$83.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $20.42 / $38.90	Professional	TC	$15.85	$20.42	$38.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $60.26 / $85.11	Facility		$17.78	$60.26	$85.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $33.88 / $60.26	Professional		$26.30	$33.88	$60.26
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $8.13 / $14.45	Professional	26	$6.31	$8.13	$14.45
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $25.12 / $45.71	Professional	TC	$19.95	$25.12	$45.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $97.72 / $269.15	Facility		$31.62	$97.72	$269.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.19 / $10.23 / $14.79	Facility	26	$2.19	$10.23	$14.79
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.03 / $28.18 / $39.81	Facility	TC	$6.03	$28.18	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $37.15 / $66.07	Professional		$26.30	$37.15	$66.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.47 / $19.95	Professional	26	$7.59	$10.47	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $25.70 / $50.12	Professional	TC	$18.62	$25.70	$50.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $40.74 / $346.74	Facility		$31.62	$40.74	$346.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $100.00 / $100.00	Facility	26	$20.89	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $54.95 / $117.49 / $117.49	Facility	TC	$54.95	$117.49	$117.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $34.67 / $223.87	Professional		$28.84	$34.67	$223.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.23 / $89.13	Professional	26	$8.71	$10.23	$89.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $24.55 / $177.83	Professional	TC	$19.50	$24.55	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $75.86 / $95.50	Facility		$10.23	$75.86	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $33.88 / $48.98	Professional		$28.84	$33.88	$48.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $9.77 / $14.79	Professional	26	$8.32	$9.77	$14.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $23.99 / $34.67	Professional	TC	$19.50	$23.99	$34.67