Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.11 / $181.10 / $416.74	Facility		$38.11	$181.10	$416.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.41 / $10.11 / $16.22	Facility	26	$8.41	$10.11	$16.22
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.64 / $188.91 / $307.33	Facility	TC	$20.64	$188.91	$307.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.77 / $36.97 / $112.60	Professional		$25.77	$36.97	$112.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.03 / $9.55 / $34.00	Professional	26	$8.03	$9.55	$34.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.72 / $20.64 / $76.86	Professional	TC	$17.72	$20.64	$76.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.61 / $25.69 / $42.34	Professional		$17.61	$25.69	$42.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.47 / $9.09 / $13.02	Professional	26	$6.47	$9.09	$13.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.82 / $26.73 / $30.94	Professional	TC	$17.82	$26.73	$30.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.86 / $31.90 / $49.47	Professional		$25.86	$31.90	$49.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.02 / $11.14 / $16.92	Professional	26	$9.02	$11.14	$16.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.55 / $21.06 / $34.31	Professional	TC	$16.55	$21.06	$34.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.39 / $73.15 / $199.12	Facility		$37.39	$73.15	$199.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $24.24 / $24.24 / $24.24	Facility	TC	$24.24	$24.24	$24.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.62 / $36.76 / $58.56	Professional		$22.62	$36.76	$58.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $12.41 / $20.30	Professional	26	$7.59	$12.41	$20.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.72 / $24.24 / $41.89	Professional	TC	$15.72	$24.24	$41.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.36 / $42.43 / $224.28	Facility		$26.36	$42.43	$224.28
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $20.47 / $70.00 / $70.00	Facility	26	$20.47	$70.00	$70.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $45.10 / $96.88 / $96.88	Facility	TC	$45.10	$96.88	$96.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.57 / $35.51 / $193.62	Professional		$26.57	$35.51	$193.62
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.01 / $11.79 / $55.28	Professional	26	$9.01	$11.79	$55.28
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $17.43 / $22.66 / $138.27	Professional	TC	$17.43	$22.66	$138.27
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $50.99 / $50.99 / $50.99	Professional		$50.99	$50.99	$50.99
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $15.79 / $15.79 / $15.79	Professional	26	$15.79	$15.79	$15.79
United Facility/Professional Professional Modifier Low / Median / High Price $26.57 / $32.56 / $55.06	Professional		$26.57	$32.56	$55.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.04 / $20.25	Professional	26	$8.91	$11.04	$20.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.28 / $21.56 / $38.90	Professional	TC	$17.28	$21.56	$38.90