Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.08 / $225.67 / $518.10	Facility		$35.08	$225.67	$518.10
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.45 / $8.59 / $14.35	Facility	26	$7.45	$8.59	$14.35
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.53 / $170.98 / $474.64	Facility	TC	$22.53	$170.98	$474.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.16 / $34.15 / $120.35	Professional		$12.16	$34.15	$120.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.90 / $11.37 / $39.90	Professional	26	$6.90	$11.37	$39.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $94.86 / $112.62 / $112.62	Professional	50	$94.86	$112.62	$112.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.55 / $24.19 / $98.02	Professional	TC	$18.55	$24.19	$98.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.75 / $32.93 / $46.59	Professional		$21.75	$32.93	$46.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.73 / $8.03 / $12.13	Professional	26	$5.73	$8.03	$12.13
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $35.44 / $35.44 / $35.44	Professional	50	$35.44	$35.44	$35.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.04 / $26.94 / $30.06	Professional	TC	$20.04	$26.94	$30.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.70 / $33.60 / $52.64	Professional		$26.70	$33.60	$52.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.99 / $10.54 / $17.57	Professional	26	$7.99	$10.54	$17.57
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $40.04 / $50.08 / $78.95	Professional	50	$40.04	$50.08	$78.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.71 / $23.69 / $38.60	Professional	TC	$18.71	$23.69	$38.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.36 / $83.05 / $247.79	Facility		$48.36	$83.05	$247.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.85 / $26.85 / $26.85	Facility	TC	$26.85	$26.85	$26.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.24 / $37.72 / $61.74	Professional		$23.24	$37.72	$61.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.88 / $11.25 / $16.92	Professional	26	$6.88	$11.25	$16.92
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.29 / $38.29 / $38.29	Professional	50	$38.29	$38.29	$38.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.12 / $25.98 / $47.05	Professional	TC	$17.12	$25.98	$47.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.40 / $43.75 / $104.40	Facility		$28.40	$43.75	$104.40
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $18.09 / $100.00 / $100.00	Facility	26	$18.09	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $50.81 / $109.00 / $109.00	Facility	TC	$50.81	$109.00	$109.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.97 / $40.02 / $202.34	Professional		$27.97	$40.02	$202.34
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.17 / $11.17 / $75.00	Professional	26	$8.17	$11.17	$75.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.53 / $29.56 / $163.00	Professional	TC	$19.53	$29.56	$163.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $53.58 / $53.58 / $53.58	Professional		$53.58	$53.58	$53.58
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $13.95 / $13.95 / $13.95	Professional	26	$13.95	$13.95	$13.95
United Facility/Professional Professional Modifier Low / Median / High Price $26.91 / $34.00 / $58.05	Professional		$26.91	$34.00	$58.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $9.67 / $15.57	Professional	26	$7.79	$9.67	$15.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.11 / $23.69 / $42.00	Professional	TC	$19.11	$23.69	$42.00