Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $199.53 / $616.60	Facility		$47.86	$199.53	$616.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.71 / $11.48 / $20.89	Facility	26	$8.71	$11.48	$20.89
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.51 / $70.79 / $457.09	Facility	TC	$29.51	$70.79	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $41.69 / $154.88	Professional		$9.12	$41.69	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $15.49 / $45.71	Professional	26	$8.32	$15.49	$45.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.05 / $83.18 / $204.17	Professional	50	$19.05	$83.18	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $43.65 / $91.20	Professional	TC	$25.12	$43.65	$91.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $31.62 / $57.54	Professional		$26.30	$31.62	$57.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.55 / $14.13	Professional	26	$6.61	$9.55	$14.13
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $52.48 / $102.33	Professional	50	$38.02	$52.48	$102.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $28.84 / $53.70	Professional	TC	$19.50	$28.84	$53.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $42.66 / $67.61	Professional		$33.88	$42.66	$67.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $11.75 / $19.05	Professional	26	$9.33	$11.75	$19.05
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $50.12 / $63.10 / $102.33	Professional	50	$50.12	$63.10	$102.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $30.20 / $51.29	Professional	TC	$24.55	$30.20	$51.29
BCBS Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $33.11 / $58.88	Facility		$24.55	$33.11	$58.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $45.71 / $56.23	Professional		$43.65	$45.71	$56.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $11.22 / $15.85	Professional	26	$10.00	$11.22	$15.85
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $35.48 / $44.67	Professional	TC	$33.11	$35.48	$44.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $109.65 / $239.88	Facility		$67.61	$109.65	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $46.77 / $89.13	Professional		$30.20	$46.77	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $12.59 / $23.44	Professional	26	$8.13	$12.59	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $34.67 / $69.18	Professional	TC	$22.91	$34.67	$69.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $57.54 / $346.74	Facility		$35.48	$57.54	$346.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $100.00 / $100.00	Facility	26	$20.89	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $34.67 / $144.54 / $144.54	Facility	TC	$34.67	$144.54	$144.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $51.29 / $263.03	Professional		$33.88	$51.29	$263.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $13.18 / $79.43	Professional	26	$9.33	$13.18	$79.43
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $38.02 / $204.17	Professional	TC	$24.55	$38.02	$204.17
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $63.10 / $74.13	Professional		$58.88	$63.10	$74.13
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $16.22 / $17.38	Professional	26	$12.02	$16.22	$17.38
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $70.79 / $70.79 / $109.65	Professional	50	$70.79	$70.79	$109.65
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $47.86 / $56.23	Professional	TC	$44.67	$47.86	$56.23
United Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $72.44 / $112.20	Facility		$33.88	$72.44	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $41.69 / $67.61	Professional		$33.11	$41.69	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.47 / $17.78	Professional	26	$8.71	$10.47	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $30.90 / $51.29	Professional	TC	$23.99	$30.90	$51.29