Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.79 / $139.19 / $586.82	Facility		$32.79	$139.19	$586.82
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.69 / $16.19 / $31.33	Facility	26	$8.69	$16.19	$31.33
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.55 / $58.14 / $313.36	Facility	TC	$27.55	$58.14	$313.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.08 / $44.03 / $138.13	Professional		$24.08	$44.03	$138.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $8.92 / $36.38	Professional	26	$7.01	$8.92	$36.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $79.14 / $79.14 / $119.13	Professional	50	$79.14	$79.14	$119.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.22 / $27.56 / $74.03	Professional	TC	$20.22	$27.56	$74.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.23 / $28.49 / $40.19	Professional		$23.23	$28.49	$40.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.22 / $7.98 / $11.51	Professional	26	$6.22	$7.98	$11.51
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $36.29 / $36.29 / $36.29	Professional	50	$36.29	$36.29	$36.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.23 / $17.85 / $22.98	Professional	TC	$17.23	$17.85	$22.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $18.30 / $66.33 / $110.07	Facility		$18.30	$66.33	$110.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.93 / $28.49 / $35.61	Professional		$24.93	$28.49	$35.61
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.80 / $6.63 / $9.31	Professional	26	$5.80	$6.63	$9.31
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.12 / $21.86 / $27.32	Professional	TC	$19.12	$21.86	$27.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.20 / $189.46 / $247.64	Facility		$75.20	$189.46	$247.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.59 / $27.59 / $27.59	Facility	TC	$27.59	$27.59	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.30 / $38.09 / $64.93	Professional		$27.30	$38.09	$64.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.08 / $17.27	Professional	26	$7.08	$10.08	$17.27
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.75 / $38.75 / $38.75	Professional	50	$38.75	$38.75	$38.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.22 / $28.54 / $47.93	Professional	TC	$20.22	$28.54	$47.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.97 / $38.96 / $169.50	Facility		$30.97	$38.96	$169.50
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 $110.49 / $110.49 / $110.49	Facility	TC	$110.49	$110.49	$110.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.15 / $34.70 / $208.83	Professional		$31.15	$34.70	$208.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.14 / $9.24 / $74.30	Professional	26	$8.14	$9.24	$74.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.38 / $25.46 / $176.00	Professional	TC	$22.38	$25.46	$176.00
United Facility/Professional Professional Modifier Low / Median / High Price $31.15 / $33.72 / $59.08	Professional		$31.15	$33.72	$59.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.07 / $9.02 / $15.84	Professional	26	$8.07	$9.02	$15.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.32 / $25.07 / $41.04	Professional	TC	$22.32	$25.07	$41.04