Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.06 / $233.20 / $491.40	Facility		$48.06	$233.20	$491.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.08 / $10.01 / $19.09	Facility	26	$8.08	$10.01	$19.09
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.99 / $228.49 / $466.61	Facility	TC	$27.99	$228.49	$466.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.34 / $38.58 / $130.00	Professional		$11.34	$38.58	$130.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $13.14 / $41.36	Professional	26	$7.76	$13.14	$41.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $26.28 / $100.88 / $112.99	Professional	50	$26.28	$100.88	$112.99
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.65 / $17.50 / $20.94	Professional	52	$14.65	$17.50	$20.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.19 / $30.05 / $110.00	Professional	TC	$23.19	$30.05	$110.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.73 / $28.78 / $53.41	Professional		$20.73	$28.78	$53.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.18 / $8.50 / $12.52	Professional	26	$6.18	$8.50	$12.52
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.38 / $34.09 / $45.33	Professional	TC	$23.38	$34.09	$45.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.17 / $39.22 / $59.84	Professional		$30.17	$39.22	$59.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $11.29 / $17.66	Professional	26	$8.66	$11.29	$17.66
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $45.25 / $58.84 / $89.76	Professional	50	$45.25	$58.84	$89.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.51 / $27.23 / $46.12	Professional	TC	$21.51	$27.23	$46.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.21 / $96.89 / $247.79	Facility		$60.21	$96.89	$247.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $31.68 / $31.68 / $31.68	Facility	TC	$31.68	$31.68	$31.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.37 / $42.38 / $72.09	Professional		$26.37	$42.38	$72.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.25 / $11.89 / $18.39	Professional	26	$7.25	$11.89	$18.39
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.28 / $43.28 / $43.28	Professional	50	$43.28	$43.28	$43.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.21 / $31.13 / $55.55	Professional	TC	$20.21	$31.13	$55.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $33.68 / $51.29 / $310.89	Facility		$33.68	$51.29	$310.89
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $100.00 / $100.00	Facility	26	$19.60	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $57.08 / $127.16 / $127.16	Facility	TC	$57.08	$127.16	$127.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.57 / $45.89 / $237.03	Professional		$31.57	$45.89	$237.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.67 / $12.11 / $71.00	Professional	26	$8.67	$12.11	$71.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $33.50 / $183.85	Professional	TC	$22.39	$33.50	$183.85
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $61.42 / $61.42 / $61.42	Professional		$61.42	$61.42	$61.42
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $15.15 / $15.15 / $15.15	Professional	26	$15.15	$15.15	$15.15
United Facility/Professional Facility Modifier Low / Median / High Price $28.03 / $84.95 / $182.03	Facility		$28.03	$84.95	$182.03
United Facility/Professional Professional Modifier Low / Median / High Price $30.06 / $39.36 / $66.02	Professional		$30.06	$39.36	$66.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $10.49 / $16.54	Professional	26	$8.46	$10.49	$16.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.28 / $28.99 / $50.06	Professional	TC	$22.28	$28.99	$50.06