Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.24 / $146.00 / $469.16	Facility		$37.24	$146.00	$469.16
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.75 / $9.59 / $17.46	Facility	26	$7.75	$9.59	$17.46
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.39 / $80.34 / $553.52	Facility	TC	$24.39	$80.34	$553.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.16 / $36.34 / $150.00	Professional		$14.16	$36.34	$150.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.06 / $11.73 / $38.64	Professional	26	$7.06	$11.73	$38.64
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.88 / $60.74 / $176.30	Professional	50	$52.88	$60.74	$176.30
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.55 / $16.07 / $94.43	Professional	52	$13.55	$16.07	$94.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.19 / $24.85 / $63.27	Professional	TC	$20.19	$24.85	$63.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.23 / $26.67 / $55.22	Professional		$19.23	$26.67	$55.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.95 / $10.03 / $12.61	Professional	26	$5.95	$10.03	$12.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.60 / $31.12 / $41.53	Professional	TC	$25.60	$31.12	$41.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.88 / $35.99 / $55.00	Professional		$28.88	$35.99	$55.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $10.90 / $16.92	Professional	26	$8.30	$10.90	$16.92
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $43.32 / $53.98 / $82.50	Professional	50	$43.32	$53.98	$82.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.57 / $25.73 / $41.81	Professional	TC	$20.57	$25.73	$41.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.13 / $88.83 / $247.79	Facility		$55.13	$88.83	$247.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.46 / $40.11 / $70.51	Professional		$24.46	$40.11	$70.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.95 / $11.52 / $17.64	Professional	26	$6.95	$11.52	$17.64
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $41.47 / $41.47 / $41.47	Professional	50	$41.47	$41.47	$41.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.55 / $28.31 / $50.75	Professional	TC	$18.55	$28.31	$50.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $46.28 / $91.11	Facility		$29.51	$46.28	$91.11
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $18.72 / $100.00 / $100.00	Facility	26	$18.72	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $54.35 / $116.58 / $116.58	Facility	TC	$54.35	$116.58	$116.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.32 / $42.35 / $217.55	Professional		$29.32	$42.35	$217.55
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $11.60 / $59.45	Professional	26	$8.23	$11.60	$59.45
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.86 / $30.85 / $166.53	Professional	TC	$20.86	$30.85	$166.53
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $14.50 / $14.50 / $14.50	Professional	26	$14.50	$14.50	$14.50
United Facility/Professional Professional Modifier Low / Median / High Price $28.34 / $36.44 / $63.08	Professional		$28.34	$36.44	$63.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.98 / $9.69 / $15.87	Professional	26	$7.98	$9.69	$15.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.49 / $26.48 / $44.73	Professional	TC	$20.49	$26.48	$44.73