Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.45 / $7.98 / $15.20	Facility	26	$6.45	$7.98	$15.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.32 / $177.31 / $411.40	Facility	TC	$30.32	$177.31	$411.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.21 / $42.07 / $159.00	Professional		$20.21	$42.07	$159.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.95 / $9.68 / $33.00	Professional	26	$5.95	$9.68	$33.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $102.09 / $104.67 / $112.00	Professional	50	$102.09	$104.67	$112.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.85 / $17.94 / $26.64	Professional	52	$14.85	$17.94	$26.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.98 / $32.61 / $65.88	Professional	TC	$23.98	$32.61	$65.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.45 / $32.67 / $55.98	Professional		$28.45	$32.67	$55.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.95 / $6.98 / $10.45	Professional	26	$4.95	$6.98	$10.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.43 / $36.84 / $45.53	Professional	TC	$26.43	$36.84	$45.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.28 / $37.44 / $61.37	Professional		$30.28	$37.44	$61.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.91 / $8.99 / $13.99	Professional	26	$6.91	$8.99	$13.99
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $45.42 / $56.16 / $92.05	Professional	50	$45.42	$56.16	$92.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.03 / $29.24 / $50.36	Professional	TC	$23.03	$29.24	$50.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.66 / $7.66 / $7.66	Facility	26	$7.66	$7.66	$7.66
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.40 / $35.40 / $35.40	Facility	TC	$35.40	$35.40	$35.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.38 / $40.68 / $75.84	Professional		$25.38	$40.68	$75.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.74 / $9.31 / $14.69	Professional	26	$5.74	$9.31	$14.69
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.71 / $43.71 / $43.71	Professional	50	$43.71	$43.71	$43.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.39 / $31.63 / $57.21	Professional	TC	$20.39	$31.63	$57.21
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $15.48 / $100.00 / $100.00	Facility	26	$15.48	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $67.18 / $143.82 / $143.82	Facility	TC	$67.18	$143.82	$143.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.01 / $43.31 / $241.48	Professional		$29.01	$43.31	$241.48
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $6.73 / $9.66 / $51.19	Professional	26	$6.73	$9.66	$51.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.90 / $35.22 / $199.06	Professional	TC	$21.90	$35.22	$199.06
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $64.38 / $64.38 / $64.38	Professional		$64.38	$64.38	$64.38
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $9.30 / $12.02 / $12.02	Professional	26	$9.30	$12.02	$12.02
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $42.77 / $52.36 / $52.36	Professional	TC	$42.77	$52.36	$52.36
United Facility/Professional Professional Modifier Low / Median / High Price $27.75 / $38.44 / $68.56	Professional		$27.75	$38.44	$68.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $8.27 / $13.23	Professional	26	$6.46	$8.27	$13.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.70 / $31.56 / $57.12	Professional	TC	$22.70	$31.56	$57.12