Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $173.78 / $489.78	Facility		$31.62	$173.78	$489.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $9.77 / $17.78	Facility	26	$7.41	$9.77	$17.78
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.42 / $37.15 / $407.38	Facility	TC	$20.42	$37.15	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $30.90 / $109.65	Professional		$8.71	$30.90	$109.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $13.18 / $40.74	Professional	26	$7.08	$13.18	$40.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.78 / $79.43 / $251.19	Professional	50	$17.78	$79.43	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $28.84 / $63.10	Professional	TC	$16.98	$28.84	$63.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $21.88 / $40.74	Professional		$17.78	$21.88	$40.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $8.32 / $12.02	Professional	26	$5.75	$8.32	$12.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $23.44 / $31.62	Professional	TC	$16.22	$23.44	$31.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $31.62 / $52.48	Professional		$25.70	$31.62	$52.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.23 / $16.22	Professional	26	$8.32	$10.23	$16.22
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $47.86 / $79.43	Professional	50	$38.02	$47.86	$79.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $21.88 / $37.15	Professional	TC	$16.98	$21.88	$37.15
BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $28.18 / $51.29	Facility		$21.88	$28.18	$51.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $31.62 / $46.77	Professional		$30.20	$31.62	$46.77
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $8.71 / $13.18	Professional	26	$8.32	$8.71	$13.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $22.91 / $30.20	Professional	TC	$21.88	$22.91	$30.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $74.13 / $239.88	Facility		$50.12	$74.13	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $35.48 / $63.10	Professional		$23.44	$35.48	$63.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $10.72 / $19.95	Professional	26	$6.76	$10.72	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $25.70 / $47.86	Professional	TC	$16.22	$25.70	$47.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $41.69 / $263.03	Facility		$25.70	$41.69	$263.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $100.00 / $100.00	Facility	26	$18.20	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $45.71 / $100.00 / $263.03	Facility	TC	$45.71	$100.00	$263.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $39.81 / $186.21	Professional		$25.70	$39.81	$186.21
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.30 / $64.57	Professional	26	$7.94	$12.30	$64.57
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $27.54 / $162.18	Professional	TC	$17.38	$27.54	$162.18
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $42.66 / $51.29	Professional		$28.84	$42.66	$51.29
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $13.80 / $13.80	Professional	26	$13.80	$13.80	$13.80
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $30.90 / $30.90	Professional	TC	$30.90	$30.90	$30.90
United Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $72.44 / $112.20	Facility		$25.70	$72.44	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $31.62 / $50.12	Professional		$25.12	$31.62	$50.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.12 / $15.49	Professional	26	$7.59	$9.12	$15.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $21.38 / $35.48	Professional	TC	$17.38	$21.38	$35.48