Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $18.20 / $23.99	Facility	26	$10.00	$18.20	$23.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $41.69 / $151.36	Professional		$30.20	$41.69	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.13 / $44.67	Professional	26	$8.91	$14.13	$44.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.84 / $66.07	Professional	TC	$20.89	$28.84	$66.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $30.20 / $61.66	Professional		$27.54	$30.20	$61.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.48 / $16.98	Professional	26	$7.94	$11.48	$16.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $19.05 / $33.88	Professional	TC	$19.05	$19.05	$33.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $43.65 / $72.44	Professional		$35.48	$43.65	$72.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $15.14 / $23.44	Professional	26	$12.59	$15.14	$23.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $29.51 / $51.29	Professional	TC	$22.91	$29.51	$51.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $40.74 / $60.26	Professional		$39.81	$40.74	$60.26
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $11.48 / $17.78	Professional	26	$11.22	$11.48	$17.78
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $29.51 / $42.66	Professional	TC	$28.18	$29.51	$42.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $48.98 / $83.18	Professional		$30.90	$48.98	$83.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $15.14 / $29.51	Professional	26	$10.00	$15.14	$29.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $34.67 / $63.10	Professional	TC	$21.88	$34.67	$63.10
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $100.00 / $100.00	Facility	26	$24.55	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $51.29 / $263.03	Professional		$34.67	$51.29	$263.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.22 / $107.15	Professional	26	$10.96	$16.22	$107.15
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $34.67 / $251.19	Professional	TC	$23.44	$34.67	$251.19
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $66.07	Professional		$56.23	$56.23	$66.07
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $19.05 / $19.05	Professional	26	$19.05	$19.05	$19.05
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $44.67 / $44.67	Professional	TC	$44.67	$44.67	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $42.66 / $69.18	Professional		$33.11	$42.66	$69.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $13.18 / $21.88	Professional	26	$10.47	$13.18	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $29.51 / $47.86	Professional	TC	$22.39	$29.51	$47.86