Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $194.98 / $457.09	Facility		$24.55	$194.98	$457.09
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $9.12 / $12.30	Facility	26	$6.03	$9.12	$12.30
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.20 / $27.54 / $223.87	Facility	TC	$18.20	$27.54	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $30.20 / $66.07	Professional		$10.23	$30.20	$66.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.91 / $31.62	Professional	26	$6.03	$8.91	$31.62
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $60.26 / $158.49 / $162.18	Professional	50	$60.26	$158.49	$162.18
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.23 / $28.84 / $58.88	Professional	52	$10.23	$28.84	$58.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $22.91 / $37.15	Professional	TC	$15.85	$22.91	$37.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $23.99 / $46.77	Professional		$19.50	$23.99	$46.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $7.76 / $12.88	Professional	26	$5.75	$7.76	$12.88
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $34.67 / $34.67 / $34.67	Professional	50	$34.67	$34.67	$34.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $26.92 / $36.31	Professional	TC	$17.78	$26.92	$36.31
BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $75.86 / $102.33	Facility		$50.12	$75.86	$102.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $29.51 / $40.74	Professional		$8.13	$29.51	$40.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $24.55 / $112.20	Facility		$24.55	$24.55	$112.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $7.08 / $11.75	Facility	26	$7.08	$7.08	$11.75
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $14.79 / $14.79 / $23.99	Facility	TC	$14.79	$14.79	$23.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $28.84 / $50.12	Professional		$21.88	$28.84	$50.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $7.94 / $13.49	Professional	26	$6.61	$7.94	$13.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $19.95 / $37.15	Professional	TC	$14.79	$19.95	$37.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $35.48 / $208.93	Facility		$24.55	$35.48	$208.93
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 / $33.88 / $208.93	Professional		$26.30	$33.88	$208.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $8.71 / $67.61	Professional	26	$7.41	$8.71	$67.61
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $23.44 / $158.49	Professional	TC	$18.20	$23.44	$158.49
United Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $67.61 / $213.80	Facility		$18.20	$67.61	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $30.20 / $45.71	Professional		$25.12	$30.20	$45.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $8.32 / $12.30	Professional	26	$7.24	$8.32	$12.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $21.88 / $33.11	Professional	TC	$17.78	$21.88	$33.11