Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.20 / $219.05 / $425.20	Facility		$40.20	$219.05	$425.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.08 / $9.56 / $15.55	Facility	26	$8.08	$9.56	$15.55
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.55 / $211.70 / $402.69	Facility	TC	$23.55	$211.70	$402.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.46 / $36.38 / $122.10	Professional		$13.46	$36.38	$122.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.44 / $12.84 / $39.67	Professional	26	$7.44	$12.84	$39.67
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $39.68 / $93.46 / $119.13	Professional	50	$39.68	$93.46	$119.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.98 / $27.99 / $83.30	Professional	TC	$20.98	$27.99	$83.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.29 / $27.94 / $48.38	Professional		$24.29	$27.94	$48.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.21 / $8.52 / $12.52	Professional	26	$6.21	$8.52	$12.52
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $36.56 / $36.56 / $36.56	Professional	50	$36.56	$36.56	$36.56
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.09 / $34.09 / $52.93	Professional	TC	$34.09	$34.09	$52.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.06 / $36.51 / $66.77	Professional		$27.06	$36.51	$66.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $11.29 / $17.66	Professional	26	$8.66	$11.29	$17.66
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $40.59 / $54.52 / $100.15	Professional	50	$40.59	$54.52	$100.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.39 / $25.40 / $48.23	Professional	TC	$18.39	$25.40	$48.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.45 / $84.19 / $247.79	Facility		$64.45	$84.19	$247.79
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 $25.04 / $42.61 / $66.90	Professional		$25.04	$42.61	$66.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.25 / $11.89 / $18.39	Professional	26	$7.25	$11.89	$18.39
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 $18.66 / $30.98 / $47.69	Professional	TC	$18.66	$30.98	$47.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.76 / $45.94 / $259.67	Facility		$29.76	$45.94	$259.67
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $100.00 / $100.00	Facility	26	$19.60	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $51.52 / $110.49 / $110.49	Facility	TC	$51.52	$110.49	$110.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.83 / $42.09 / $208.83	Professional		$29.83	$42.09	$208.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $12.18 / $74.30	Professional	26	$8.66	$12.18	$74.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.26 / $30.96 / $176.00	Professional	TC	$21.26	$30.96	$176.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $15.15 / $15.15 / $15.15	Professional	26	$15.15	$15.15	$15.15
United Facility/Professional Professional Modifier Low / Median / High Price $29.35 / $35.64 / $59.66	Professional		$29.35	$35.64	$59.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.53 / $10.31 / $16.92	Professional	26	$8.53	$10.31	$16.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.90 / $26.48 / $44.37	Professional	TC	$20.90	$26.48	$44.37