Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.43 / $239.55 / $800.11	Facility		$99.43	$239.55	$800.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.70 / $45.07 / $72.83	Facility	26	$33.70	$45.07	$72.83
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $73.72 / $239.55 / $689.52	Facility	TC	$73.72	$239.55	$689.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.76 / $133.18 / $620.00	Professional		$94.76	$133.18	$620.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.02 / $44.35 / $151.40	Professional	26	$31.02	$44.35	$151.40
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $45.59 / $51.74 / $66.59	Professional	52	$45.59	$51.74	$66.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.23 / $85.50 / $220.02	Professional	TC	$63.23	$85.50	$220.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.00 / $80.30 / $92.35	Professional		$73.00	$80.30	$92.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.80 / $35.57 / $55.08	Professional	26	$25.80	$35.57	$55.08
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $60.92 / $60.92 / $118.21	Professional	TC	$60.92	$60.92	$118.21
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 $102.79 / $129.29 / $228.11	Professional		$102.79	$129.29	$228.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.50 / $45.06 / $72.48	Professional	26	$36.50	$45.06	$72.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.29 / $83.31 / $160.08	Professional	TC	$66.29	$83.31	$160.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $136.69 / $243.14 / $455.25	Facility		$136.69	$243.14	$455.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.13 / $40.13 / $40.13	Facility	26	$40.13	$40.13	$40.13
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $82.40 / $82.40 / $82.40	Facility	TC	$82.40	$82.40	$82.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.77 / $141.03 / $239.73	Professional		$86.77	$141.03	$239.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.57 / $46.11 / $85.03	Professional	26	$29.57	$46.11	$85.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.05 / $93.05 / $168.51	Professional	TC	$59.05	$93.05	$168.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $99.50 / $155.22 / $361.20	Facility		$99.50	$155.22	$361.20
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $82.37 / $157.44 / $157.44	Facility	26	$82.37	$157.44	$157.44
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $155.00 / $331.53 / $331.53	Facility	TC	$155.00	$331.53	$331.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $111.68 / $142.65 / $704.47	Professional		$111.68	$142.65	$704.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.34 / $46.02 / $290.60	Professional	26	$35.34	$46.02	$290.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $75.11 / $98.72 / $483.33	Professional	TC	$75.11	$98.72	$483.33
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $63.34 / $63.34 / $63.34	Professional	26	$63.34	$63.34	$63.34
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 $105.92 / $126.64 / $226.12	Professional		$105.92	$126.64	$226.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.78 / $41.28 / $76.20	Professional	26	$33.78	$41.28	$76.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.38 / $88.85 / $148.82	Professional	TC	$73.38	$88.85	$148.82