Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $181.97 / $524.81	Facility		$48.98	$181.97	$524.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $11.22 / $218.78	Facility	26	$8.13	$11.22	$218.78
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.90 / $74.13 / $467.74	Facility	TC	$30.90	$74.13	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $38.90 / $138.04	Professional		$8.71	$38.90	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $14.45 / $41.69	Professional	26	$7.76	$14.45	$41.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.05 / $102.33 / $194.98	Professional	50	$19.05	$102.33	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $43.65 / $85.11	Professional	TC	$26.30	$43.65	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $30.90 / $54.95	Professional		$26.30	$30.90	$54.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $8.91 / $13.18	Professional	26	$6.17	$8.91	$13.18
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $43.65 / $50.12 / $104.71	Professional	50	$43.65	$50.12	$104.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $30.20 / $50.12	Professional	TC	$20.42	$30.20	$50.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $40.74 / $67.61	Professional		$33.11	$40.74	$67.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.72 / $16.60	Professional	26	$8.71	$10.72	$16.60
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $48.98 / $61.66 / $100.00	Professional	50	$48.98	$61.66	$100.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $30.20 / $50.12	Professional	TC	$24.55	$30.20	$50.12
BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $30.20 / $52.48	Facility		$22.39	$30.20	$52.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $46.77 / $56.23	Professional		$43.65	$46.77	$56.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $10.47 / $13.18	Professional	26	$9.33	$10.47	$13.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $37.15 / $44.67	Professional	TC	$33.88	$37.15	$44.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $112.20 / $239.88	Facility		$69.18	$112.20	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $46.77 / $89.13	Professional		$29.51	$46.77	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $11.75 / $21.38	Professional	26	$7.41	$11.75	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $35.48 / $70.79	Professional	TC	$22.91	$35.48	$70.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $56.23 / $275.42	Facility		$35.48	$56.23	$275.42
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 $70.79 / $151.36 / $151.36	Facility	TC	$70.79	$151.36	$151.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $47.86 / $263.03	Professional		$32.36	$47.86	$263.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $13.18 / $67.61	Professional	26	$8.51	$13.18	$67.61
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $38.90 / $208.93	Professional	TC	$24.55	$38.90	$208.93
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $63.10 / $74.13	Professional		$54.95	$63.10	$74.13
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $15.85 / $16.22	Professional	26	$15.14	$15.85	$16.22
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $89.13 / $89.13 / $102.33	Professional	50	$89.13	$89.13	$102.33
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $48.98 / $54.95	Professional	TC	$46.77	$48.98	$54.95
United Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $72.44 / $112.20	Facility		$35.48	$72.44	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $41.69 / $67.61	Professional		$31.62	$41.69	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $9.77 / $16.60	Professional	26	$8.13	$9.77	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $31.62 / $52.48	Professional	TC	$23.44	$31.62	$52.48