Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.02 / $185.37 / $392.31	Facility		$41.02	$185.37	$392.31
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.41 / $10.42 / $18.70	Facility	26	$8.41	$10.42	$18.70
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.36 / $185.37 / $470.19	Facility	TC	$26.36	$185.37	$470.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.01 / $36.08 / $137.60	Professional		$12.01	$36.08	$137.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.74 / $12.01 / $41.50	Professional	26	$7.74	$12.01	$41.50
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $18.76 / $88.72 / $145.41	Professional	50	$18.76	$88.72	$145.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $26.13 / $64.84	Professional	TC	$22.39	$26.13	$64.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.52 / $28.18 / $30.49	Professional		$24.52	$28.18	$30.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.47 / $9.69 / $13.02	Professional	26	$6.47	$9.69	$13.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $43.70 / $43.70 / $43.70	Professional	TC	$43.70	$43.70	$43.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.22 / $37.31 / $65.14	Professional		$30.22	$37.31	$65.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.02 / $11.51 / $18.85	Professional	26	$9.02	$11.51	$18.85
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $45.33 / $55.96 / $97.71	Professional	50	$45.33	$55.96	$97.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.20 / $26.52 / $45.37	Professional	TC	$21.20	$26.52	$45.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.71 / $100.97 / $247.79	Facility		$44.71	$100.97	$247.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $30.20 / $30.20	Facility	TC	$30.20	$30.20	$30.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.67 / $43.16 / $69.54	Professional		$26.67	$43.16	$69.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.65 / $12.55 / $19.71	Professional	26	$7.65	$12.55	$19.71
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.28 / $43.28 / $43.28	Professional	50	$43.28	$43.28	$43.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.71 / $30.23 / $52.85	Professional	TC	$19.71	$30.23	$52.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.05 / $49.25 / $109.33	Facility		$31.05	$49.25	$109.33
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $20.47 / $70.00 / $70.00	Facility	26	$20.47	$70.00	$70.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $27.85 / $122.62 / $122.62	Facility	TC	$27.85	$122.62	$122.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.36 / $42.01 / $226.14	Professional		$31.36	$42.01	$226.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.64 / $55.28	Professional	26	$8.91	$11.64	$55.28
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.73 / $170.86	Professional	TC	$21.88	$28.73	$170.86
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $15.79 / $15.79 / $23.69	Professional	26	$15.79	$15.79	$23.69
United Facility/Professional Professional Modifier Low / Median / High Price $31.36 / $38.29 / $65.40	Professional		$31.36	$38.29	$65.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.81 / $10.76 / $17.60	Professional	26	$8.81	$10.76	$17.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.79 / $28.73 / $47.59	Professional	TC	$21.79	$28.73	$47.59