Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.33 / $296.83 / $739.21	Facility		$95.33	$296.83	$739.21
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.19 / $35.34 / $58.54	Facility	26	$27.19	$35.34	$58.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $59.83 / $244.61 / $616.67	Facility	TC	$59.83	$244.61	$616.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.78 / $107.68 / $559.00	Professional		$76.78	$107.68	$559.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.07 / $40.79 / $118.68	Professional	26	$25.07	$40.79	$118.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.03 / $71.45 / $224.87	Professional	TC	$52.03	$71.45	$224.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.01 / $69.08 / $74.31	Professional		$62.01	$69.08	$74.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.65 / $26.91 / $43.99	Professional	26	$20.65	$26.91	$43.99
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $38.49 / $45.28 / $96.21	Professional	TC	$38.49	$45.28	$96.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $363.00 / $363.00 / $413.00	Facility		$363.00	$363.00	$413.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.72 / $102.49 / $180.71	Professional		$82.72	$102.49	$180.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.87 / $36.03 / $57.78	Professional	26	$28.87	$36.03	$57.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.85 / $67.68 / $125.75	Professional	TC	$53.85	$67.68	$125.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $135.22 / $202.32 / $455.25	Facility		$135.22	$202.32	$455.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.67 / $31.67 / $31.67	Facility	26	$31.67	$31.67	$31.67
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $66.73 / $66.73 / $66.73	Facility	TC	$66.73	$66.73	$66.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.67 / $112.32 / $194.36	Professional		$69.67	$112.32	$194.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.80 / $36.36 / $67.98	Professional	26	$23.80	$36.36	$67.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.80 / $76.53 / $139.25	Professional	TC	$47.80	$76.53	$139.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.62 / $127.40 / $424.26	Facility		$80.62	$127.40	$424.26
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $65.77 / $125.66 / $125.66	Facility	26	$65.77	$125.66	$125.66
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $125.56 / $267.93 / $267.93	Facility	TC	$125.56	$267.93	$267.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.48 / $114.11 / $568.24	Professional		$89.48	$114.11	$568.24
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $28.64 / $38.26 / $227.85	Professional	26	$28.64	$38.26	$227.85
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $59.66 / $80.25 / $390.02	Professional	TC	$59.66	$80.25	$390.02
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $148.33 / $148.33 / $148.33	Professional		$148.33	$148.33	$148.33
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $47.85 / $47.85 / $50.59	Professional	26	$47.85	$47.85	$50.59
United Facility/Professional Facility Modifier Low / Median / High Price $114.42 / $136.18 / $250.18	Facility		$114.42	$136.18	$250.18
United Facility/Professional Professional Modifier Low / Median / High Price $84.83 / $102.03 / $182.00	Professional		$84.83	$102.03	$182.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $33.35 / $60.33	Professional	26	$26.96	$33.35	$60.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.52 / $70.83 / $112.87	Professional	TC	$56.52	$70.83	$112.87