Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.54 / $166.36 / $612.48	Facility		$40.54	$166.36	$612.48
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.57 / $16.63 / $35.54	Facility	26	$9.57	$16.63	$35.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $38.27 / $169.98 / $612.48	Facility	TC	$38.27	$169.98	$612.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.80 / $44.51 / $135.78	Professional		$23.80	$44.51	$135.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.21 / $9.57 / $41.36	Professional	26	$7.21	$9.57	$41.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $57.92 / $111.78 / $114.57	Professional	50	$57.92	$111.78	$114.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.64 / $32.84 / $110.00	Professional	TC	$21.64	$32.84	$110.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.54 / $32.54 / $37.15	Professional		$26.54	$32.54	$37.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.38 / $11.17 / $13.81	Professional	26	$6.38	$11.17	$13.81
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $41.44 / $48.82 / $53.07	Professional	50	$41.44	$48.82	$53.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.55 / $21.27 / $41.10	Professional	TC	$20.55	$21.27	$41.10
BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.56 / $78.73 / $129.06	Facility		$22.56	$78.73	$129.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.60 / $32.68 / $40.85	Professional		$28.60	$32.68	$40.85
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.80 / $6.63 / $9.33	Professional	26	$5.80	$6.63	$9.33
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.79 / $26.05 / $32.56	Professional	TC	$22.79	$26.05	$32.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.33 / $189.46 / $247.64	Facility		$66.33	$189.46	$247.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $32.44 / $32.44 / $32.44	Facility	TC	$32.44	$32.44	$32.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.67 / $39.22 / $65.15	Professional		$28.67	$39.22	$65.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.08 / $17.27	Professional	26	$7.08	$10.08	$17.27
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.28 / $43.28 / $43.28	Professional	50	$43.28	$43.28	$43.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.79 / $28.44 / $48.43	Professional	TC	$20.79	$28.44	$48.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $32.65 / $42.43 / $221.60	Facility		$32.65	$42.43	$221.60
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $131.69 / $131.69 / $131.69	Facility	TC	$131.69	$131.69	$131.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.97 / $35.36 / $234.86	Professional		$29.97	$35.36	$234.86
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.09 / $9.02 / $67.70	Professional	26	$8.09	$9.02	$67.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.60 / $26.35 / $181.68	Professional	TC	$21.60	$26.35	$181.68
United Facility/Professional Facility Modifier Low / Median / High Price $80.90 / $80.90 / $195.48	Facility		$80.90	$80.90	$195.48
United Facility/Professional Professional Modifier Low / Median / High Price $29.16 / $35.36 / $56.59	Professional		$29.16	$35.36	$56.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.09 / $9.02 / $15.84	Professional	26	$8.09	$9.02	$15.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.08 / $26.35 / $42.48	Professional	TC	$21.08	$26.35	$42.48