Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $114.82 / $398.11	Facility		$38.02	$114.82	$398.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $10.96 / $19.95	Facility	26	$8.32	$10.96	$19.95
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.12 / $40.74 / $398.11	Facility	TC	$25.12	$40.74	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $33.88 / $123.03	Professional		$8.51	$33.88	$123.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $13.18 / $43.65	Professional	26	$7.59	$13.18	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $28.18 / $138.04 / $177.83	Professional	50	$28.18	$138.04	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $32.36 / $74.13	Professional	TC	$20.89	$32.36	$74.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $28.18 / $58.88	Professional		$22.39	$28.18	$58.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.33 / $12.30	Professional	26	$6.46	$9.33	$12.30
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $89.13 / $89.13 / $89.13	Professional	50	$89.13	$89.13	$89.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $31.62 / $48.98	Professional	TC	$24.55	$31.62	$48.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $36.31 / $61.66	Professional		$30.20	$36.31	$61.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $10.72 / $16.60	Professional	26	$9.12	$10.72	$16.60
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $45.71 / $54.95 / $91.20	Professional	50	$45.71	$54.95	$91.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $24.55 / $44.67	Professional	TC	$21.38	$24.55	$44.67
BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $32.36 / $56.23	Facility		$30.20	$32.36	$56.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $38.90 / $53.70	Professional		$36.31	$38.90	$53.70
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $9.77 / $14.13	Professional	26	$9.33	$9.77	$14.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $29.51 / $37.15	Professional	TC	$26.92	$29.51	$37.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $93.33 / $245.47	Facility		$44.67	$93.33	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $41.69 / $75.86	Professional		$27.54	$41.69	$75.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.02 / $22.91	Professional	26	$7.76	$12.02	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $30.90 / $57.54	Professional	TC	$19.50	$30.90	$57.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $48.98 / $138.04	Facility		$30.90	$48.98	$138.04
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $70.79 / $70.79	Facility	26	$20.42	$70.79	$70.79
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $57.54 / $123.03 / $123.03	Facility	TC	$57.54	$123.03	$123.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $42.66 / $223.87	Professional		$30.20	$42.66	$223.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.02 / $54.95	Professional	26	$8.32	$12.02	$54.95
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.20 / $169.82	Professional	TC	$21.88	$30.20	$169.82
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $57.54 / $61.66	Professional		$51.29	$57.54	$61.66
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.22 / $16.22	Professional	26	$16.22	$16.22	$16.22
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $38.90 / $38.90	Professional	TC	$38.90	$38.90	$38.90
United Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $72.44 / $112.20	Facility		$32.36	$72.44	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $37.15 / $60.26	Professional		$30.20	$37.15	$60.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $10.47 / $17.78	Professional	26	$8.51	$10.47	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $26.30 / $43.65	Professional	TC	$21.38	$26.30	$43.65