Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.54 / $211.70 / $491.62	Facility		$33.54	$211.70	$491.62
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.45 / $9.41 / $205.47	Facility	26	$7.45	$9.41	$205.47
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.96 / $185.37 / $410.94	Facility	TC	$20.96	$185.37	$410.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.21 / $30.95 / $116.06	Professional		$11.21	$30.95	$116.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $11.83 / $40.88	Professional	26	$7.03	$11.83	$40.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $73.23 / $80.53 / $80.53	Professional	50	$73.23	$80.53	$80.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.21 / $22.70 / $62.25	Professional	TC	$18.21	$22.70	$62.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.20 / $25.10 / $48.17	Professional		$20.20	$25.10	$48.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.73 / $7.84 / $10.97	Professional	26	$5.73	$7.84	$10.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.10 / $18.10 / $26.39	Professional	TC	$18.10	$18.10	$26.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.45 / $31.57 / $52.58	Professional		$25.45	$31.57	$52.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $10.50 / $16.23	Professional	26	$8.30	$10.50	$16.23
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.17 / $47.35 / $78.87	Professional	50	$38.17	$47.35	$78.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.14 / $22.04 / $36.36	Professional	TC	$17.14	$22.04	$36.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.05 / $79.67 / $247.79	Facility		$50.05	$79.67	$247.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $24.24 / $24.24 / $24.24	Facility	TC	$24.24	$24.24	$24.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.58 / $36.75 / $57.22	Professional		$22.58	$36.75	$57.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.66 / $11.09 / $16.92	Professional	26	$6.66	$11.09	$16.92
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $36.49 / $36.49 / $36.49	Professional	50	$36.49	$36.49	$36.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.11 / $26.00 / $42.59	Professional	TC	$16.11	$26.00	$42.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.73 / $41.44 / $195.00	Facility		$26.73	$41.44	$195.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $18.09 / $100.00 / $100.00	Facility	26	$18.09	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $45.82 / $100.00 / $100.00	Facility	TC	$45.82	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.63 / $38.36 / $187.12	Professional		$27.63	$38.36	$187.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.09 / $11.60 / $64.39	Professional	26	$8.09	$11.60	$64.39
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $18.71 / $26.77 / $161.00	Professional	TC	$18.71	$26.77	$161.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $49.70 / $49.70 / $49.70	Professional		$49.70	$49.70	$49.70
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $13.95 / $13.95 / $13.95	Professional	26	$13.95	$13.95	$13.95
United Facility/Professional Facility Modifier Low / Median / High Price $44.29 / $112.55 / $185.87	Facility		$44.29	$112.55	$185.87
United Facility/Professional Professional Modifier Low / Median / High Price $26.31 / $31.57 / $58.46	Professional		$26.31	$31.57	$58.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.06 / $9.96 / $16.46	Professional	26	$8.06	$9.96	$16.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.16 / $22.78 / $38.50	Professional	TC	$18.16	$22.78	$38.50