Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $213.80 / $489.78	Facility		$33.88	$213.80	$489.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $9.55 / $17.78	Facility	26	$7.41	$9.55	$17.78
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.39 / $40.74 / $478.63	Facility	TC	$22.39	$40.74	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $33.11 / $117.49	Professional		$8.51	$33.11	$117.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $12.88 / $42.66	Professional	26	$7.08	$12.88	$42.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $16.60 / $72.44 / $158.49	Professional	50	$16.60	$72.44	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $32.36 / $67.61	Professional	TC	$19.05	$32.36	$67.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $24.55 / $43.65	Professional		$19.95	$24.55	$43.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $7.94 / $12.02	Professional	26	$5.75	$7.94	$12.02
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $66.07 / $66.07 / $79.43	Professional	50	$66.07	$66.07	$79.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $21.88 / $35.48	Professional	TC	$15.49	$21.88	$35.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $33.11 / $53.70	Professional		$26.92	$33.11	$53.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.23 / $16.60	Professional	26	$7.94	$10.23	$16.60
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.81 / $50.12 / $81.28	Professional	50	$39.81	$50.12	$81.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $22.91 / $38.90	Professional	TC	$18.62	$22.91	$38.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $27.54 / $51.29	Facility		$21.88	$27.54	$51.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.88 / $44.67	Professional		$32.36	$33.88	$44.67
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $8.71 / $13.18	Professional	26	$8.32	$8.71	$13.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $25.70 / $33.11	Professional	TC	$23.44	$25.70	$33.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $83.18 / $239.88	Facility		$47.86	$83.18	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $37.15 / $69.18	Professional		$23.44	$37.15	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.96 / $20.42	Professional	26	$7.08	$10.96	$20.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $26.92 / $51.29	Professional	TC	$16.98	$26.92	$51.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $44.67 / $199.53	Facility		$27.54	$44.67	$199.53
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 / $40.74 / $204.17	Professional		$26.30	$40.74	$204.17
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.02 / $75.86	Professional	26	$7.94	$12.02	$75.86
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $29.51 / $162.18	Professional	TC	$19.05	$29.51	$162.18
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $46.77 / $54.95	Professional		$45.71	$46.77	$54.95
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $14.45 / $14.45	Professional	26	$13.80	$14.45	$14.45
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $33.88 / $40.74	Professional	TC	$33.88	$33.88	$40.74
United Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $72.44 / $112.20	Facility		$26.30	$72.44	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $33.11 / $52.48	Professional		$26.30	$33.11	$52.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $9.33 / $15.14	Professional	26	$7.41	$9.33	$15.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $23.44 / $38.90	Professional	TC	$18.20	$23.44	$38.90