Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $218.78 / $588.84	Facility		$81.28	$218.78	$588.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $38.90 / $75.86	Facility	26	$31.62	$38.90	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $97.72 / $436.52	Professional		$50.12	$97.72	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $66.07 / $169.82	Professional	26	$28.84	$66.07	$169.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.48 / $151.36 / $676.08	Professional	50	$52.48	$151.36	$676.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $57.54 / $239.88	Professional	TC	$41.69	$57.54	$239.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $66.07 / $109.65	Professional		$60.26	$66.07	$109.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $38.02 / $52.48	Professional	26	$24.55	$38.02	$52.48
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $81.28 / $91.20 / $97.72	Professional	50	$81.28	$91.20	$97.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $45.71 / $66.07	Professional	TC	$32.36	$45.71	$66.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $97.72 / $158.49	Professional		$81.28	$97.72	$158.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $38.90 / $63.10	Professional	26	$33.88	$38.90	$63.10
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $120.23 / $144.54 / $239.88	Professional	50	$120.23	$144.54	$239.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $56.23 / $95.50	Professional	TC	$46.77	$56.23	$95.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $87.10 / $204.17	Facility		$75.86	$87.10	$204.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $93.33 / $134.90	Professional		$85.11	$93.33	$134.90
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $37.15 / $53.70	Professional	26	$33.88	$37.15	$53.70
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $56.23 / $81.28	Professional	TC	$51.29	$56.23	$81.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $177.83 / $245.47	Facility		$104.71	$177.83	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $104.71 / $213.80	Professional		$70.79	$104.71	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $43.65 / $85.11	Professional	26	$28.18	$43.65	$85.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $66.07 / $131.83	Professional	TC	$43.65	$66.07	$131.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $120.23 / $331.13	Facility		$75.86	$120.23	$331.13
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $147.91 / $147.91	Facility	26	$75.86	$147.91	$147.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $102.33 / $549.54	Professional		$77.62	$102.33	$549.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $41.69 / $204.17	Professional	26	$30.90	$41.69	$204.17
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $61.66 / $338.84	Professional	TC	$46.77	$61.66	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $85.11 / $125.89	Facility		$64.57	$85.11	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $93.33 / $151.36	Professional		$77.62	$93.33	$151.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $37.15 / $58.88	Professional	26	$30.90	$37.15	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $57.54 / $91.20	Professional	TC	$46.77	$57.54	$91.20