Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.07 / $212.64 / $504.02	Facility		$45.07	$212.64	$504.02
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $10.25 / $16.75	Facility	26	$7.76	$10.25	$16.75
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.05 / $212.64 / $485.74	Facility	TC	$26.05	$212.64	$485.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.27 / $39.74 / $124.39	Professional		$12.27	$39.74	$124.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.21 / $12.35 / $41.36	Professional	26	$7.21	$12.35	$41.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $39.67 / $89.43 / $119.52	Professional	50	$39.67	$89.43	$119.52
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.70 / $16.25 / $19.46	Professional	52	$13.70	$16.25	$19.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.71 / $30.18 / $82.33	Professional	TC	$21.71	$30.18	$82.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.81 / $29.45 / $47.39	Professional		$20.81	$29.45	$47.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.95 / $8.40 / $12.03	Professional	26	$5.95	$8.40	$12.03
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $44.30 / $66.81	Professional	50	$38.02	$44.30	$66.81
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.71 / $32.57 / $56.55	Professional	TC	$21.71	$32.57	$56.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.30 / $35.04 / $58.91	Professional		$28.30	$35.04	$58.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.35 / $10.89 / $17.66	Professional	26	$8.35	$10.89	$17.66
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.45 / $52.56 / $88.36	Professional	50	$42.45	$52.56	$88.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $25.26 / $42.35	Professional	TC	$19.95	$25.26	$42.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.52 / $89.97 / $247.79	Facility		$58.52	$89.97	$247.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.25 / $9.25 / $9.25	Facility	26	$9.25	$9.25	$9.25
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.46 / $29.46 / $29.46	Facility	TC	$29.46	$29.46	$29.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.00 / $41.23 / $66.93	Professional		$26.00	$41.23	$66.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.06 / $11.59 / $19.00	Professional	26	$7.06	$11.59	$19.00
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.56 / $40.56 / $40.56	Professional	50	$40.56	$40.56	$40.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.79 / $30.05 / $51.03	Professional	TC	$18.79	$30.05	$51.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.27 / $48.23 / $277.45	Facility		$31.27	$48.23	$277.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $18.97 / $100.00 / $100.00	Facility	26	$18.97	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $50.67 / $118.08 / $118.08	Facility	TC	$50.67	$118.08	$118.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.88 / $43.99 / $221.82	Professional		$29.88	$43.99	$221.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.44 / $11.67 / $71.00	Professional	26	$8.44	$11.67	$71.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.89 / $31.56 / $170.86	Professional	TC	$21.89	$31.56	$170.86
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $54.50 / $57.55 / $57.55	Professional		$54.50	$57.55	$57.55
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $14.59 / $14.59 / $19.78	Professional	26	$14.59	$14.59	$19.78
United Facility/Professional Facility Modifier Low / Median / High Price $44.29 / $112.55 / $185.87	Facility		$44.29	$112.55	$185.87
United Facility/Professional Professional Modifier Low / Median / High Price $28.87 / $36.85 / $62.94	Professional		$28.87	$36.85	$62.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.07 / $10.11 / $16.45	Professional	26	$8.07	$10.11	$16.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.82 / $26.69 / $45.36	Professional	TC	$20.82	$26.69	$45.36