Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.89 / $170.00 / $468.08	Facility		$46.89	$170.00	$468.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.35 / $15.29 / $22.84	Facility	26	$10.35	$15.29	$22.84
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.02 / $236.31 / $435.20	Facility	TC	$33.02	$236.31	$435.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.86 / $43.11 / $163.12	Professional		$35.86	$43.11	$163.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.43 / $12.99 / $36.54	Professional	26	$9.43	$12.99	$36.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.29 / $38.29 / $38.29	Professional	50	$38.29	$38.29	$38.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.57 / $29.05 / $62.69	Professional	TC	$25.57	$29.05	$62.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.02 / $61.02 / $68.02	Professional		$61.02	$61.02	$68.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $11.18 / $16.93	Professional	26	$7.95	$11.18	$16.93
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.47 / $44.47 / $44.47	Professional	TC	$44.47	$44.47	$44.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.77 / $43.85 / $79.43	Professional		$34.77	$43.85	$79.43
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.09 / $14.06 / $23.17	Professional	26	$11.09	$14.06	$23.17
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $52.15 / $65.56 / $119.14	Professional	50	$52.15	$65.56	$119.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.68 / $30.39 / $55.27	Professional	TC	$23.68	$30.39	$55.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.33 / $114.70 / $455.25	Facility		$54.33	$114.70	$455.25
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 $34.29 / $34.29 / $34.29	Facility	TC	$34.29	$34.29	$34.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.18 / $51.30 / $83.58	Professional		$32.18	$51.30	$83.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.43 / $15.43 / $24.14	Professional	26	$9.43	$15.43	$24.14
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $49.64 / $49.64 / $49.64	Professional	50	$49.64	$49.64	$49.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.45 / $36.26 / $59.94	Professional	TC	$22.45	$36.26	$59.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.99 / $56.92 / $133.31	Facility		$35.99	$56.92	$133.31
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 $65.04 / $139.28 / $139.28	Facility	TC	$65.04	$139.28	$139.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.79 / $49.31 / $265.10	Professional		$37.79	$49.31	$265.10
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.97 / $14.09 / $68.20	Professional	26	$10.97	$14.09	$68.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $34.63 / $196.89	Professional	TC	$26.30	$34.63	$196.89
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $70.17 / $70.17 / $70.17	Professional		$70.17	$70.17	$70.17
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 $37.02 / $45.60 / $75.81	Professional		$37.02	$45.60	$75.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.75 / $13.43 / $21.78	Professional	26	$10.75	$13.43	$21.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.24 / $32.00 / $53.49	Professional	TC	$26.24	$32.00	$53.49