Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.52 / $187.58 / $421.98	Facility		$43.52	$187.58	$421.98
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.75 / $9.59 / $15.62	Facility	26	$7.75	$9.59	$15.62
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.48 / $211.70 / $437.54	Facility	TC	$25.48	$211.70	$437.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.26 / $35.75 / $114.96	Professional		$9.26	$35.75	$114.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.14 / $11.57 / $41.22	Professional	26	$7.14	$11.57	$41.22
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.11 / $103.59 / $214.03	Professional	50	$47.11	$103.59	$214.03
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.68 / $16.23 / $18.80	Professional	52	$13.68	$16.23	$18.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.46 / $28.00 / $105.00	Professional	TC	$20.46	$28.00	$105.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.82 / $29.05 / $49.96	Professional		$19.82	$29.05	$49.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.92 / $8.38 / $12.61	Professional	26	$5.92	$8.38	$12.61
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $43.57 / $43.57 / $43.57	Professional	50	$43.57	$43.57	$43.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $30.23 / $32.57	Professional	TC	$16.98	$30.23	$32.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.00 / $141.00 / $384.00	Facility		$128.00	$141.00	$384.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.19 / $37.29 / $55.54	Professional		$29.19	$37.29	$55.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $10.99 / $17.66	Professional	26	$8.30	$10.99	$17.66
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $43.78 / $55.93 / $83.31	Professional	50	$43.78	$55.93	$83.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $26.37 / $42.35	Professional	TC	$20.89	$26.37	$42.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.44 / $89.97 / $247.79	Facility		$53.44	$89.97	$247.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.46 / $29.46 / $29.46	Facility	TC	$29.46	$29.46	$29.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.69 / $40.53 / $66.91	Professional		$24.69	$40.53	$66.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.06 / $11.57 / $17.78	Professional	26	$7.06	$11.57	$17.78
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $41.91 / $41.91 / $41.91	Professional	50	$41.91	$41.91	$41.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.79 / $28.19 / $52.24	Professional	TC	$18.79	$28.19	$52.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.37 / $47.81 / $165.85	Facility		$30.37	$47.81	$165.85
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $18.72 / $100.00 / $100.00	Facility	26	$18.72	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $55.06 / $118.08 / $118.08	Facility	TC	$55.06	$118.08	$118.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.77 / $43.98 / $219.71	Professional		$29.77	$43.98	$219.71
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $11.69 / $67.70	Professional	26	$8.56	$11.69	$67.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $31.56 / $168.70	Professional	TC	$21.38	$31.56	$168.70
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $57.45 / $57.45 / $57.45	Professional		$57.45	$57.45	$57.45
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $14.50 / $14.50 / $14.50	Professional	26	$14.50	$14.50	$14.50
United Facility/Professional Facility Modifier Low / Median / High Price $44.29 / $112.55 / $185.87	Facility		$44.29	$112.55	$185.87
United Facility/Professional Professional Modifier Low / Median / High Price $28.95 / $36.86 / $63.32	Professional		$28.95	$36.86	$63.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.10 / $10.15 / $17.32	Professional	26	$8.10	$10.15	$17.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.67 / $26.90 / $47.42	Professional	TC	$20.67	$26.90	$47.42