Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.64 / $165.00 / $469.90	Facility		$29.64	$165.00	$469.90
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.87 / $8.86 / $15.38	Facility	26	$6.87	$8.86	$15.38
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.23 / $81.78 / $364.71	Facility	TC	$20.23	$81.78	$364.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.03 / $34.02 / $135.49	Professional		$24.03	$34.02	$135.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.58 / $11.41 / $42.47	Professional	26	$6.58	$11.41	$42.47
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $31.68 / $63.36 / $94.79	Professional	50	$31.68	$63.36	$94.79
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.59 / $13.84 / $159.60	Professional	52	$11.59	$13.84	$159.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.44 / $20.32 / $54.59	Professional	TC	$17.44	$20.32	$54.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.43 / $21.20 / $39.58	Professional		$17.43	$21.20	$39.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.45 / $9.02 / $11.65	Professional	26	$5.45	$9.02	$11.65
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $35.17 / $35.17 / $35.17	Professional	50	$35.17	$35.17	$35.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.52 / $30.59 / $50.49	Professional		$24.52	$30.59	$50.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.68 / $10.01 / $16.23	Professional	26	$7.68	$10.01	$16.23
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $36.78 / $45.88 / $75.73	Professional	50	$36.78	$45.88	$75.73
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.84 / $21.95 / $34.28	Professional	TC	$16.84	$21.95	$34.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $49.20 / $78.54 / $247.79	Facility		$49.20	$78.54	$247.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $8.51 / $8.51	Facility	26	$8.51	$8.51	$8.51
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $23.86 / $23.86 / $23.86	Facility	TC	$23.86	$23.86	$23.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.07 / $35.79 / $55.28	Professional		$22.07	$35.79	$55.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.47 / $10.63 / $16.20	Professional	26	$6.47	$10.63	$16.20
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.13 / $35.13 / $35.13	Professional	50	$35.13	$35.13	$35.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.22 / $25.29 / $41.85	Professional	TC	$15.22	$25.29	$41.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.08 / $40.00 / $84.15	Facility		$25.08	$40.00	$84.15
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $17.46 / $100.00 / $100.00	Facility	26	$17.46	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $44.39 / $100.00 / $100.00	Facility	TC	$44.39	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.62 / $36.95 / $180.63	Professional		$26.62	$36.95	$180.63
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.71 / $10.68 / $67.70	Professional	26	$7.71	$10.68	$67.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $18.39 / $26.29 / $154.00	Professional	TC	$18.39	$26.29	$154.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $13.40 / $13.40 / $20.09	Professional	26	$13.40	$13.40	$20.09
United Facility/Professional Professional Modifier Low / Median / High Price $25.79 / $30.98 / $52.49	Professional		$25.79	$30.98	$52.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.54 / $9.28 / $15.09	Professional	26	$7.54	$9.28	$15.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.16 / $22.56 / $37.81	Professional	TC	$18.16	$22.56	$37.81