Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $15.14 / $23.99	Facility	26	$7.94	$15.14	$23.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $33.11 / $125.89	Professional		$23.99	$33.11	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $8.91 / $30.90	Professional	26	$6.46	$8.91	$30.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $23.99 / $60.26	Professional	TC	$16.98	$23.99	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $23.99 / $48.98	Professional		$23.99	$23.99	$48.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $6.31 / $8.91	Professional	26	$6.17	$6.31	$8.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $17.38 / $19.50	Professional	TC	$17.38	$17.38	$19.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $35.48 / $60.26	Professional		$28.84	$35.48	$60.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.72 / $17.38	Professional	26	$8.71	$10.72	$17.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $25.12 / $40.74	Professional	TC	$19.95	$25.12	$40.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $35.48 / $45.71	Professional		$33.88	$35.48	$45.71
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $9.33 / $14.13	Professional	26	$9.12	$9.33	$14.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $25.70 / $37.15	Professional	TC	$25.12	$25.70	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $39.81 / $70.79	Professional		$25.70	$39.81	$70.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $11.48 / $21.38	Professional	26	$7.41	$11.48	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $28.84 / $54.95	Professional	TC	$18.20	$28.84	$54.95
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $19.50 / $100.00 / $100.00	Facility	26	$19.50	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $41.69 / $208.93	Professional		$28.84	$41.69	$208.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.02 / $66.07	Professional	26	$8.32	$12.02	$66.07
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $30.20 / $186.21	Professional	TC	$19.95	$30.20	$186.21
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $56.23	Professional		$47.86	$47.86	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $34.67 / $54.95	Professional		$28.18	$34.67	$54.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.77 / $16.60	Professional	26	$7.94	$9.77	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $24.55 / $40.74	Professional	TC	$19.50	$24.55	$40.74