Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.53 / $234.76 / $326.77	Facility		$115.53	$234.76	$326.77
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.30 / $28.50 / $28.50	Facility	26	$16.30	$28.50	$28.50
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $128.52 / $241.15 / $293.18	Facility	TC	$128.52	$241.15	$293.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.80 / $65.34 / $161.22	Professional		$28.80	$65.34	$161.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.30 / $22.02 / $62.41	Professional	26	$16.30	$22.02	$62.41
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $234.74 / $234.74 / $435.00	Professional	50	$234.74	$234.74	$435.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.22 / $16.25 / $44.27	Professional	52	$14.22	$16.25	$44.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.33 / $30.45 / $110.07	Professional	TC	$12.33	$30.45	$110.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.95 / $38.95 / $38.95	Professional		$38.95	$38.95	$38.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.73 / $71.00 / $114.22	Professional		$47.73	$71.00	$114.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.41 / $27.00 / $44.78	Professional	26	$21.41	$27.00	$44.78
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $71.59 / $106.50 / $171.33	Professional	50	$71.59	$106.50	$171.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.32 / $46.00 / $74.34	Professional	TC	$22.32	$46.00	$74.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.38 / $41.38 / $118.51	Facility		$41.38	$41.38	$118.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.35 / $23.35 / $23.35	Facility	26	$23.35	$23.35	$23.35
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $18.64 / $18.64 / $18.64	Facility	TC	$18.64	$18.64	$18.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.45 / $77.47 / $136.79	Professional		$36.45	$77.47	$136.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.98 / $31.74 / $47.32	Professional	26	$19.98	$31.74	$47.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.21 / $42.02 / $90.05	Professional	TC	$16.21	$42.02	$90.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.96 / $60.88 / $180.04	Facility		$31.96	$60.88	$180.04
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $47.60 / $100.00 / $100.00	Facility	26	$47.60	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $52.28 / $141.03 / $141.03	Facility	TC	$52.28	$141.03	$141.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.83 / $67.23 / $402.37	Professional		$44.83	$67.23	$402.37
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $18.89 / $27.14 / $130.60	Professional	26	$18.89	$27.14	$130.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.13 / $43.77 / $284.52	Professional	TC	$22.13	$43.77	$284.52
United Facility/Professional Professional Modifier Low / Median / High Price $39.90 / $54.46 / $104.22	Professional		$39.90	$54.46	$104.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.71 / $23.66 / $42.65	Professional	26	$18.71	$23.66	$42.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.25 / $27.13 / $59.60	Professional	TC	$20.25	$27.13	$59.60