Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.62 / $240.18 / $606.72	Facility		$50.62	$240.18	$606.72
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.08 / $10.01 / $19.09	Facility	26	$8.08	$10.01	$19.09
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.99 / $230.21 / $546.67	Facility	TC	$27.99	$230.21	$546.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.17 / $39.95 / $125.78	Professional		$12.17	$39.95	$125.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.44 / $12.95 / $47.30	Professional	26	$7.44	$12.95	$47.30
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $16.18 / $102.48 / $126.78	Professional	50	$16.18	$102.48	$126.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.51 / $31.47 / $121.00	Professional	TC	$24.51	$31.47	$121.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.74 / $31.89 / $54.85	Professional		$21.74	$31.89	$54.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.21 / $8.74 / $13.35	Professional	26	$6.21	$8.74	$13.35
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $41.67 / $41.67 / $70.09	Professional	50	$41.67	$41.67	$70.09
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.99 / $36.32 / $63.07	Professional	TC	$32.99	$36.32	$63.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.17 / $39.04 / $59.84	Professional		$30.17	$39.04	$59.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $11.29 / $17.66	Professional	26	$8.66	$11.29	$17.66
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $45.25 / $58.84 / $89.76	Professional	50	$45.25	$58.84	$89.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.51 / $27.14 / $45.98	Professional	TC	$21.51	$27.14	$45.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.37 / $100.35 / $247.79	Facility		$59.37	$100.35	$247.79
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 $26.84 / $42.95 / $72.19	Professional		$26.84	$42.95	$72.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.25 / $11.89 / $18.39	Professional	26	$7.25	$11.89	$18.39
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 $20.39 / $30.99 / $56.72	Professional	TC	$20.39	$30.99	$56.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $33.65 / $50.82 / $244.71	Facility		$33.65	$50.82	$244.71
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $100.00 / $100.00	Facility	26	$19.60	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $54.21 / $131.69 / $131.69	Facility	TC	$54.21	$131.69	$131.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.57 / $45.60 / $234.86	Professional		$31.57	$45.60	$234.86
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.67 / $12.11 / $67.70	Professional	26	$8.67	$12.11	$67.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $33.27 / $181.68	Professional	TC	$22.39	$33.27	$181.68
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $59.80 / $63.08 / $63.08	Professional		$59.80	$63.08	$63.08
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $15.15 / $20.59 / $22.72	Professional	26	$15.15	$20.59	$22.72
United Facility/Professional Facility Modifier Low / Median / High Price $28.03 / $84.95 / $182.03	Facility		$28.03	$84.95	$182.03
United Facility/Professional Professional Modifier Low / Median / High Price $30.06 / $37.94 / $67.20	Professional		$30.06	$37.94	$67.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $10.34 / $16.54	Professional	26	$8.46	$10.34	$16.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.22 / $28.93 / $48.81	Professional	TC	$22.22	$28.93	$48.81