Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $102.33 / $446.68	Facility		$41.69	$102.33	$446.68
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $14.79 / $24.55	Facility	26	$10.23	$14.79	$24.55
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.84 / $50.12 / $407.38	Facility	TC	$28.84	$50.12	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $47.86 / $151.36	Professional		$33.11	$47.86	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $15.49 / $37.15	Professional	26	$8.91	$15.49	$37.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $26.92 / $120.23 / $204.17	Professional	50	$26.92	$120.23	$204.17
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.98 / $16.98 / $77.62	Professional	52	$16.98	$16.98	$77.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $32.36 / $67.61	Professional	TC	$23.99	$32.36	$67.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $37.15 / $67.61	Professional		$29.51	$37.15	$67.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $12.30 / $17.78	Professional	26	$8.13	$12.30	$17.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $35.48 / $51.29	Professional	TC	$20.42	$35.48	$51.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $43.65 / $70.79	Professional		$34.67	$43.65	$70.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $13.18 / $20.42	Professional	26	$10.96	$13.18	$20.42
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $52.48 / $64.57 / $107.15	Professional	50	$52.48	$64.57	$107.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $30.20 / $52.48	Professional	TC	$23.44	$30.20	$52.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $39.81 / $70.79	Facility		$37.15	$39.81	$70.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $45.71 / $66.07	Professional		$43.65	$45.71	$66.07
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $12.02 / $17.38	Professional	26	$11.48	$12.02	$17.38
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $33.88 / $45.71	Professional	TC	$30.90	$33.88	$45.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $107.15 / $457.09	Facility		$54.95	$107.15	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $91.20	Professional		$32.36	$50.12	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $14.79 / $28.18	Professional	26	$9.55	$14.79	$28.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $35.48 / $67.61	Professional	TC	$23.44	$35.48	$67.61
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $57.54 / $281.84	Facility		$35.48	$57.54	$281.84
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $70.79 / $70.79	Facility	26	$25.12	$70.79	$70.79
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $64.57 / $138.04 / $138.04	Facility	TC	$64.57	$138.04	$138.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $48.98 / $263.03	Professional		$34.67	$48.98	$263.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $14.45 / $67.61	Professional	26	$10.23	$14.45	$67.61
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $34.67 / $194.98	Professional	TC	$24.55	$34.67	$194.98
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $61.66 / $72.44	Professional		$58.88	$61.66	$72.44
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $19.50 / $19.95	Professional	26	$19.50	$19.50	$19.95
Qualchoice Facility/Professional Professional Modifier 52 Low / Median / High Price $17.38 / $17.38 / $17.38	Professional	52	$17.38	$17.38	$17.38
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $44.67 / $52.48	Professional	TC	$44.67	$44.67	$52.48
United Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $100.00 / $181.97	Facility		$39.81	$100.00	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $44.67 / $72.44	Professional		$34.67	$44.67	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $12.88 / $21.38	Professional	26	$10.23	$12.88	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $30.90 / $51.29	Professional	TC	$24.55	$30.90	$51.29