Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.71 / $178.06 / $497.08	Facility		$34.71	$178.06	$497.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.75 / $9.41 / $16.75	Facility	26	$7.75	$9.41	$16.75
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.89 / $47.19 / $357.68	Facility	TC	$21.89	$47.19	$357.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.62 / $32.29 / $197.61	Professional		$13.62	$32.29	$197.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.05 / $11.57 / $46.55	Professional	26	$7.05	$11.57	$46.55
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.52 / $88.20 / $175.02	Professional	50	$47.52	$88.20	$175.02
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.25 / $15.03 / $192.44	Professional	52	$13.25	$15.03	$192.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.02 / $22.58 / $59.42	Professional	TC	$18.02	$22.58	$59.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.24 / $27.35 / $51.43	Professional		$22.24	$27.35	$51.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.92 / $10.03 / $13.19	Professional	26	$5.92	$10.03	$13.19
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.77 / $38.77 / $38.77	Professional	50	$38.77	$38.77	$38.77
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.25 / $32.25 / $32.25	Professional	TC	$32.25	$32.25	$32.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.39 / $33.32 / $51.91	Professional		$26.39	$33.32	$51.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $10.80 / $16.23	Professional	26	$8.30	$10.80	$16.23
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.58 / $49.51 / $77.86	Professional	50	$39.58	$49.51	$77.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.09 / $22.95 / $37.53	Professional	TC	$18.09	$22.95	$37.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $49.20 / $87.25 / $455.25	Facility		$49.20	$87.25	$455.25
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 $26.47 / $26.47 / $26.47	Facility	TC	$26.47	$26.47	$26.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $36.96 / $61.09	Professional		$22.91	$36.96	$61.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.66 / $11.25 / $17.64	Professional	26	$6.66	$11.25	$17.64
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $37.85 / $37.85 / $37.85	Professional	50	$37.85	$37.85	$37.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.89 / $26.15 / $45.76	Professional	TC	$16.89	$26.15	$45.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.72 / $42.74 / $86.49	Facility		$27.72	$42.74	$86.49
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 $49.38 / $105.96 / $105.96	Facility	TC	$49.38	$105.96	$105.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.50 / $40.22 / $200.17	Professional		$27.50	$40.22	$200.17
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $11.59 / $61.09	Professional	26	$8.23	$11.59	$61.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $18.97 / $28.26 / $154.00	Professional	TC	$18.97	$28.26	$154.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $14.50 / $14.50 / $21.76	Professional	26	$14.50	$14.50	$21.76
United Facility/Professional Facility Modifier Low / Median / High Price $114.42 / $136.18 / $250.18	Facility		$114.42	$136.18	$250.18
United Facility/Professional Professional Modifier Low / Median / High Price $26.61 / $32.99 / $57.46	Professional		$26.61	$32.99	$57.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.96 / $9.89 / $15.88	Professional	26	$7.96	$9.89	$15.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.57 / $23.67 / $40.61	Professional	TC	$18.57	$23.67	$40.61