Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $169.82 / $371.54	Facility		$44.67	$169.82	$371.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $269.15 / $269.15 / $331.13	Facility	TC	$269.15	$269.15	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $79.43 / $288.40	Professional		$34.67	$79.43	$288.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $23.99 / $77.62	Professional	26	$9.33	$23.99	$77.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $34.67 / $190.55	Professional	TC	$21.88	$34.67	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $36.31 / $41.69	Professional		$18.20	$36.31	$41.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.68 / $10.00 / $15.14	Professional	26	$4.68	$10.00	$15.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $26.92 / $29.51	Professional	TC	$13.49	$26.92	$29.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $112.20	Professional		$32.36	$50.12	$112.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $18.20 / $60.26	Professional	26	$10.00	$18.20	$60.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $35.48 / $61.66	Professional	TC	$22.39	$35.48	$61.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $48.98 / $100.00	Professional		$37.15	$48.98	$100.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $13.18 / $20.42	Professional	26	$9.77	$13.18	$20.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $35.48 / $77.62	Professional	TC	$27.54	$35.48	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $29.51 / $144.54	Professional		$19.05	$29.51	$144.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.25 / $9.33 / $128.82	Professional	26	$5.25	$9.33	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $24.55 / $120.23	Professional	TC	$13.80	$24.55	$120.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $53.70 / $131.83	Facility		$36.31	$53.70	$131.83
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $165.96 / $165.96 / $165.96	Facility	TC	$165.96	$165.96	$165.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $74.13 / $363.08	Professional		$25.12	$74.13	$363.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $15.85 / $190.55	Professional	26	$7.08	$15.85	$190.55
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $52.48 / $269.15	Professional	TC	$17.78	$52.48	$269.15
United Facility/Professional Facility Modifier Low / Median / High Price $5.37 / $15.49 / $20.89	Facility		$5.37	$15.49	$20.89
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $40.74 / $107.15	Professional		$25.12	$40.74	$107.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $11.75 / $27.54	Professional	26	$6.61	$11.75	$27.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $28.84 / $79.43	Professional	TC	$17.78	$28.84	$79.43