Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.79 / $195.00 / $482.40	Facility		$61.79	$195.00	$482.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.35 / $11.91 / $19.94	Facility	26	$10.35	$11.91	$19.94
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $37.04 / $211.70 / $421.35	Facility	TC	$37.04	$211.70	$421.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.10 / $47.40 / $165.89	Professional		$11.10	$47.40	$165.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.43 / $12.72 / $44.80	Professional	26	$9.43	$12.72	$44.80
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.08 / $46.08 / $82.34	Professional	50	$46.08	$46.08	$82.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.44 / $35.09 / $132.80	Professional	TC	$28.44	$35.09	$132.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.75 / $35.40 / $66.38	Professional		$27.75	$35.40	$66.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $10.83 / $15.26	Professional	26	$7.95	$10.83	$15.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.88 / $46.73 / $53.64	Professional	TC	$30.88	$46.73	$53.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.81 / $48.13 / $82.94	Professional		$38.81	$48.13	$82.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.09 / $13.69 / $23.17	Professional	26	$11.09	$13.69	$23.17
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $58.21 / $72.19 / $124.41	Professional	50	$58.21	$72.19	$124.41
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.73 / $34.69 / $59.52	Professional	TC	$27.73	$34.69	$59.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.45 / $138.36 / $247.79	Facility		$58.45	$138.36	$247.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $41.38 / $41.38 / $41.38	Facility	TC	$41.38	$41.38	$41.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.01 / $55.32 / $95.31	Professional		$36.01	$55.32	$95.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.32 / $15.27 / $23.57	Professional	26	$9.32	$15.27	$23.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.29 / $40.43 / $72.83	Professional	TC	$26.29	$40.43	$72.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.52 / $65.23 / $221.41	Facility		$41.52	$65.23	$221.41
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $25.22 / $70.00 / $70.00	Facility	26	$25.22	$70.00	$70.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $34.27 / $168.01 / $168.01	Facility	TC	$34.27	$168.01	$168.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.94 / $54.36 / $301.95	Professional		$39.94	$54.36	$301.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.03 / $14.48 / $68.20	Professional	26	$11.03	$14.48	$68.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.14 / $38.43 / $233.75	Professional	TC	$29.14	$38.43	$233.75
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $80.68 / $80.68 / $80.68	Professional		$80.68	$80.68	$80.68
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $19.47 / $19.47 / $19.47	Professional	26	$19.47	$19.47	$19.47
United Facility/Professional Professional Modifier Low / Median / High Price $39.47 / $49.35 / $86.96	Professional		$39.47	$49.35	$86.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $13.43 / $21.16	Professional	26	$10.83	$13.43	$21.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.70 / $35.72 / $63.01	Professional	TC	$28.70	$35.72	$63.01