Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.23 / $225.26 / $578.24	Facility		$49.23	$225.26	$578.24
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.73 / $11.70 / $18.82	Facility	26	$8.73	$11.70	$18.82
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.45 / $212.64 / $572.15	Facility	TC	$25.45	$212.64	$572.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.45 / $38.56 / $116.23	Professional		$10.45	$38.56	$116.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $12.32 / $42.46	Professional	26	$7.95	$12.32	$42.46
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $14.58 / $87.02 / $113.34	Professional	50	$14.58	$87.02	$113.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $28.78 / $95.00	Professional	TC	$19.64	$28.78	$95.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.00 / $29.64 / $48.33	Professional		$21.00	$29.64	$48.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.67 / $9.16 / $13.51	Professional	26	$6.67	$9.16	$13.51
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.77 / $44.47 / $44.47	Professional	50	$38.77	$44.47	$44.47
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.43 / $29.13 / $37.22	Professional	TC	$21.43	$29.13	$37.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.42 / $37.14 / $58.47	Professional		$27.42	$37.14	$58.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $11.90 / $19.11	Professional	26	$9.33	$11.90	$19.11
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $41.13 / $55.71 / $87.70	Professional	50	$41.13	$55.71	$87.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.09 / $24.82 / $41.29	Professional	TC	$18.09	$24.82	$41.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.59 / $88.83 / $247.79	Facility		$52.59	$88.83	$247.79
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 $25.35 / $41.64 / $67.59	Professional		$25.35	$41.64	$67.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.85 / $12.93 / $19.86	Professional	26	$7.85	$12.93	$19.86
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 $18.18 / $28.84 / $50.27	Professional	TC	$18.18	$28.84	$50.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.58 / $48.96 / $262.64	Facility		$31.58	$48.96	$262.64
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $21.10 / $100.00 / $100.00	Facility	26	$21.10	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $54.35 / $116.58 / $116.58	Facility	TC	$54.35	$116.58	$116.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.74 / $44.02 / $221.82	Professional		$30.74	$44.02	$221.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $13.05 / $89.16	Professional	26	$9.27	$13.05	$89.16
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.98 / $30.98 / $177.00	Professional	TC	$20.98	$30.98	$177.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $58.74 / $58.74 / $58.74	Professional		$58.74	$58.74	$58.74
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $16.34 / $16.34 / $16.34	Professional	26	$16.34	$16.34	$16.34
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $42.39 / $42.39 / $42.39	Professional	TC	$42.39	$42.39	$42.39
United Facility/Professional Professional Modifier Low / Median / High Price $29.14 / $36.92 / $63.57	Professional		$29.14	$36.92	$63.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.06 / $11.12 / $17.84	Professional	26	$9.06	$11.12	$17.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.25 / $25.77 / $41.44	Professional	TC	$20.25	$25.77	$41.44