Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.51 / $212.64 / $414.45	Facility		$40.51	$212.64	$414.45
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.92 / $13.31 / $22.34	Facility	26	$9.92	$13.31	$22.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.16 / $35.36 / $129.74	Professional		$21.16	$35.36	$129.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.43 / $12.72 / $43.21	Professional	26	$9.43	$12.72	$43.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.00 / $25.17 / $64.20	Professional	TC	$21.00	$25.17	$64.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.38 / $27.37 / $46.73	Professional		$22.38	$27.37	$46.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $13.03 / $16.93	Professional	26	$7.94	$13.03	$16.93
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.71 / $21.71 / $21.71	Professional	TC	$21.71	$21.71	$21.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.35 / $38.90 / $64.25	Professional		$31.35	$38.90	$64.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.09 / $14.45 / $22.79	Professional	26	$11.09	$14.45	$22.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.26 / $25.65 / $42.35	Professional	TC	$20.26	$25.65	$42.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.28 / $89.97 / $247.79	Facility		$54.28	$89.97	$247.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $11.95	Facility	26	$11.95	$11.95	$11.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.48 / $44.41 / $72.22	Professional		$27.48	$44.41	$72.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.14 / $14.99 / $23.57	Professional	26	$9.14	$14.99	$23.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.79 / $29.85 / $51.03	Professional	TC	$18.79	$29.85	$51.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $32.77 / $51.19 / $107.05	Facility		$32.77	$51.19	$107.05
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $25.22 / $100.00 / $100.00	Facility	26	$25.22	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.08 / $47.39 / $236.90	Professional		$33.08	$47.39	$236.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.98 / $15.47 / $82.56	Professional	26	$10.98	$15.47	$82.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.05 / $31.92 / $190.00	Professional	TC	$22.05	$31.92	$190.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $19.47 / $19.47 / $19.47	Professional	26	$19.47	$19.47	$19.47
United Facility/Professional Facility Modifier Low / Median / High Price $44.29 / $112.55 / $185.87	Facility		$44.29	$112.55	$185.87
United Facility/Professional Professional Modifier Low / Median / High Price $32.47 / $40.09 / $67.91	Professional		$32.47	$40.09	$67.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $12.96 / $22.03	Professional	26	$10.83	$12.96	$22.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.44 / $26.83 / $45.48	Professional	TC	$21.44	$26.83	$45.48