Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $251.19 / $630.96	Facility		$42.66	$251.19	$630.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.71 / $27.54 / $37.15	Facility	26	$8.71	$27.54	$37.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $35.48 / $57.54 / $158.49	Facility	TC	$35.48	$57.54	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $33.88 / $107.15	Professional		$9.77	$33.88	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $14.13 / $46.77	Professional	26	$7.08	$14.13	$46.77
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $16.98 / $77.62 / $158.49	Professional	50	$16.98	$77.62	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $28.84 / $72.44	Professional	TC	$17.38	$28.84	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $25.12 / $41.69	Professional		$19.50	$25.12	$41.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $7.24 / $12.88	Professional	26	$5.62	$7.24	$12.88
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.15 / $37.15 / $37.15	Professional	50	$37.15	$37.15	$37.15
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $20.42 / $39.81	Professional	TC	$14.79	$20.42	$39.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $16.60 / $60.26 / $83.18	Facility		$16.60	$60.26	$83.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $30.20 / $54.95	Professional		$23.99	$30.20	$54.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.37 / $6.92 / $12.30	Professional	26	$5.37	$6.92	$12.30
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $23.44 / $42.66	Professional	TC	$19.05	$23.44	$42.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $81.28 / $269.15	Facility		$26.92	$81.28	$269.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.86 / $8.71 / $12.59	Facility	26	$1.86	$8.71	$12.59
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.62 / $26.30 / $37.15	Facility	TC	$5.62	$26.30	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $33.88 / $60.26	Professional		$23.99	$33.88	$60.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.55 / $16.98	Professional	26	$6.46	$9.55	$16.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $23.99 / $46.77	Professional	TC	$16.98	$23.99	$46.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $37.15 / $398.11	Facility		$28.18	$37.15	$398.11
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $100.00 / $100.00	Facility	26	$18.20	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $51.29 / $109.65 / $109.65	Facility	TC	$51.29	$109.65	$109.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $31.62 / $204.17	Professional		$26.30	$31.62	$204.17
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $8.91 / $75.86	Professional	26	$7.76	$8.91	$75.86
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $22.91 / $162.18	Professional	TC	$18.20	$22.91	$162.18
United Facility/Professional Facility Modifier Low / Median / High Price $9.77 / $75.86 / $95.50	Facility		$9.77	$75.86	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $30.90 / $45.71	Professional		$26.30	$30.90	$45.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $8.51 / $13.18	Professional	26	$7.76	$8.51	$13.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $22.91 / $32.36	Professional	TC	$18.20	$22.91	$32.36