Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.82 / $228.49 / $564.62	Facility		$53.82	$228.49	$564.62
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.73 / $10.33 / $16.76	Facility	26	$8.73	$10.33	$16.76
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.92 / $216.93 / $460.42	Facility	TC	$30.92	$216.93	$460.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.50 / $44.71 / $154.00	Professional		$12.50	$44.71	$154.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.36 / $13.66 / $43.24	Professional	26	$8.36	$13.66	$43.24
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.72 / $111.14 / $143.50	Professional	50	$17.72	$111.14	$143.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.14 / $19.23 / $22.99	Professional	52	$16.14	$19.23	$22.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.52 / $33.89 / $78.76	Professional	TC	$24.52	$33.89	$78.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.85 / $32.20 / $59.74	Professional		$28.85	$32.20	$59.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.67 / $9.43 / $14.21	Professional	26	$6.67	$9.43	$14.21
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $43.28 / $48.02 / $79.18	Professional	50	$43.28	$48.02	$79.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.43 / $39.65 / $68.89	Professional	TC	$26.43	$39.65	$68.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.64 / $43.78 / $69.58	Professional		$33.64	$43.78	$69.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $12.26 / $19.11	Professional	26	$9.33	$12.26	$19.11
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $50.46 / $65.67 / $102.97	Professional	50	$50.46	$65.67	$102.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.31 / $30.78 / $53.29	Professional	TC	$24.31	$30.78	$53.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.98 / $109.58 / $247.79	Facility		$66.98	$109.58	$247.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.79 / $35.79 / $35.79	Facility	TC	$35.79	$35.79	$35.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.47 / $47.15 / $79.23	Professional		$29.47	$47.15	$79.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.85 / $12.93 / $19.86	Professional	26	$7.85	$12.93	$19.86
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.26 / $48.26 / $48.26	Professional	50	$48.26	$48.26	$48.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.83 / $34.90 / $61.88	Professional	TC	$22.83	$34.90	$61.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.01 / $56.73 / $311.42	Facility		$37.01	$56.73	$311.42
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $21.10 / $100.00 / $100.00	Facility	26	$21.10	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $23.26 / $143.82 / $143.82	Facility	TC	$23.26	$143.82	$143.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.54 / $49.35 / $263.06	Professional		$34.54	$49.35	$263.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.35 / $13.05 / $79.26	Professional	26	$9.35	$13.05	$79.26
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.47 / $36.88 / $205.55	Professional	TC	$25.47	$36.88	$205.55
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $68.70 / $68.70 / $68.70	Professional		$68.70	$68.70	$68.70
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $16.34 / $16.34 / $24.52	Professional	26	$16.34	$16.34	$24.52
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $50.32 / $50.32 / $50.32	Professional	TC	$50.32	$50.32	$50.32
United Facility/Professional Professional Modifier Low / Median / High Price $33.86 / $44.66 / $74.51	Professional		$33.86	$44.66	$74.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.06 / $11.04 / $18.25	Professional	26	$9.06	$11.04	$18.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $32.74 / $54.57	Professional	TC	$25.12	$32.74	$54.57