Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.72 / $151.66 / $391.21	Facility		$34.72	$151.66	$391.21
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.06 / $9.30 / $16.82	Facility	26	$7.06	$9.30	$16.82
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.14 / $184.80 / $361.48	Facility	TC	$23.14	$184.80	$361.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.45 / $33.40 / $108.00	Professional		$15.45	$33.40	$108.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.05 / $11.38 / $45.00	Professional	26	$7.05	$11.38	$45.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.57 / $65.48 / $103.24	Professional	50	$33.57	$65.48	$103.24
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.01 / $15.46 / $41.92	Professional	52	$13.01	$15.46	$41.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.10 / $23.15 / $56.85	Professional	TC	$19.10	$23.15	$56.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.69 / $23.87 / $41.78	Professional		$18.69	$23.87	$41.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.69 / $8.59 / $12.13	Professional	26	$5.69	$8.59	$12.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.94 / $34.90 / $52.85	Professional		$27.94	$34.90	$52.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $10.80 / $16.23	Professional	26	$8.30	$10.80	$16.23
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $41.91 / $52.35 / $79.27	Professional	50	$41.91	$52.35	$79.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $24.68 / $39.68	Professional	TC	$19.64	$24.68	$39.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.90 / $84.19 / $247.79	Facility		$50.90	$84.19	$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 $27.59 / $27.59 / $27.59	Facility	TC	$27.59	$27.59	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.27 / $37.93 / $63.68	Professional		$23.27	$37.93	$63.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.66 / $11.18 / $16.92	Professional	26	$6.66	$11.18	$16.92
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.11 / $40.11 / $40.11	Professional	50	$40.11	$40.11	$40.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.60 / $26.59 / $48.53	Professional	TC	$17.60	$26.59	$48.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.33 / $44.48 / $86.49	Facility		$28.33	$44.48	$86.49
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 $51.52 / $110.49 / $110.49	Facility	TC	$51.52	$110.49	$110.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.20 / $41.41 / $206.66	Professional		$28.20	$41.41	$206.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $11.59 / $67.70	Professional	26	$8.23	$11.59	$67.70
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $58.50 / $58.50 / $58.50	Professional	52	$58.50	$58.50	$58.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.12 / $29.56 / $157.81	Professional	TC	$20.12	$29.56	$157.81
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $13.95 / $13.95 / $20.93	Professional	26	$13.95	$13.95	$20.93
United Facility/Professional Facility Modifier Low / Median / High Price $84.95 / $112.55 / $185.87	Facility		$84.95	$112.55	$185.87
United Facility/Professional Professional Modifier Low / Median / High Price $27.43 / $35.64 / $64.23	Professional		$27.43	$35.64	$64.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.96 / $9.92 / $15.88	Professional	26	$7.96	$9.92	$15.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.79 / $24.47 / $44.34	Professional	TC	$19.79	$24.47	$44.34