Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $288.40 / $660.69	Facility		$33.88	$288.40	$660.69
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $29.51 / $40.74	Facility	26	$9.55	$29.51	$40.74
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.62 / $66.07 / $158.49	Facility	TC	$31.62	$66.07	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $36.31 / $117.49	Professional		$9.55	$36.31	$117.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $14.13 / $42.66	Professional	26	$7.41	$14.13	$42.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $34.67 / $89.13 / $213.80	Professional	50	$34.67	$89.13	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $36.31 / $89.13	Professional	TC	$19.05	$36.31	$89.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $28.18 / $45.71	Professional		$20.42	$28.18	$45.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $6.76 / $13.18	Professional	26	$6.17	$6.76	$13.18
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $32.36 / $36.31 / $45.71	Professional	50	$32.36	$36.31	$45.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $18.20 / $40.74	Professional	TC	$14.45	$18.20	$40.74
BCBS Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $60.26 / $83.18	Facility		$16.98	$60.26	$83.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $30.90 / $56.23	Professional		$25.12	$30.90	$56.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $7.41 / $13.18	Professional	26	$5.75	$7.41	$13.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $23.99 / $43.65	Professional	TC	$19.05	$23.99	$43.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $112.20 / $269.15	Facility		$33.88	$112.20	$269.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.62 / $26.30 / $38.02	Facility	TC	$5.62	$26.30	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $38.02 / $66.07	Professional		$26.92	$38.02	$66.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $9.77 / $18.20	Professional	26	$6.92	$9.77	$18.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $27.54 / $48.98	Professional	TC	$19.50	$27.54	$48.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $40.74 / $186.21	Facility		$29.51	$40.74	$186.21
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 $51.29 / $109.65 / $109.65	Facility	TC	$51.29	$109.65	$109.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $34.67 / $208.93	Professional		$30.90	$34.67	$208.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $9.55 / $74.13	Professional	26	$8.13	$9.55	$74.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $25.70 / $177.83	Professional	TC	$22.39	$25.70	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $9.77 / $75.86 / $95.50	Facility		$9.77	$75.86	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $33.88 / $51.29	Professional		$30.90	$33.88	$51.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.12 / $13.80	Professional	26	$7.94	$9.12	$13.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $25.12 / $38.90	Professional	TC	$22.39	$25.12	$38.90