Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.19 / $208.52 / $579.00	Facility		$82.19	$208.52	$579.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.41 / $38.95 / $60.01	Facility	26	$31.41	$38.95	$60.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.01 / $92.36 / $442.00	Professional		$54.01	$92.36	$442.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.72 / $49.90 / $127.90	Professional	26	$28.72	$49.90	$127.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $51.99 / $239.70 / $675.00	Professional	50	$51.99	$239.70	$675.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.70 / $54.25 / $200.15	Professional	TC	$45.70	$54.25	$200.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.73 / $63.52 / $79.40	Professional		$60.73	$63.52	$79.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.02 / $33.61 / $51.24	Professional	26	$24.02	$33.61	$51.24
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $91.10 / $94.92 / $104.79	Professional	50	$91.10	$94.92	$104.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $43.66 / $43.66 / $43.66	Professional	TC	$43.66	$43.66	$43.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.41 / $98.67 / $160.84	Professional		$80.41	$98.67	$160.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.71 / $39.52 / $63.91	Professional	26	$33.71	$39.52	$63.91
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $120.61 / $148.00 / $241.26	Professional	50	$120.61	$148.00	$241.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.70 / $58.11 / $96.94	Professional	TC	$46.70	$58.11	$96.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $105.22 / $181.08 / $247.79	Facility		$105.22	$181.08	$247.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.03 / $37.03 / $37.03	Facility	26	$37.03	$37.03	$37.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.29 / $107.08 / $185.34	Professional		$68.29	$107.08	$185.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.29 / $42.82 / $78.54	Professional	26	$28.29	$42.82	$78.54
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $113.75 / $113.75 / $113.75	Professional	50	$113.75	$113.75	$113.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.40 / $65.42 / $114.67	Professional	TC	$42.40	$65.42	$114.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.08 / $121.08 / $303.77	Facility		$75.08	$121.08	$303.77
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $76.50 / $146.86 / $146.86	Facility	26	$76.50	$146.86	$146.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $80.70 / $101.56 / $546.22	Professional		$80.70	$101.56	$546.22
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.61 / $40.46 / $203.94	Professional	26	$32.61	$40.46	$203.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $49.04 / $61.30 / $342.28	Professional	TC	$49.04	$61.30	$342.28
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $58.93 / $58.93 / $58.93	Professional	26	$58.93	$58.93	$58.93
United Facility/Professional Facility Modifier Low / Median / High Price $84.95 / $112.55 / $185.87	Facility		$84.95	$112.55	$185.87
United Facility/Professional Professional Modifier Low / Median / High Price $78.38 / $97.18 / $178.28	Professional		$78.38	$97.18	$178.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.84 / $38.35 / $64.25	Professional	26	$30.84	$38.35	$64.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.14 / $57.21 / $104.84	Professional	TC	$47.14	$57.21	$104.84