Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.31 / $14.19 / $23.78	Facility	26	$12.31	$14.19	$23.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.27 / $44.50 / $153.86	Professional		$28.27	$44.50	$153.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.21 / $14.67 / $60.49	Professional	26	$11.21	$14.67	$60.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.12 / $29.80 / $76.00	Professional	TC	$24.12	$29.80	$76.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.05 / $31.30 / $55.52	Professional		$29.05	$31.30	$55.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.46 / $12.95 / $18.13	Professional	26	$9.46	$12.95	$18.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.64 / $34.64 / $34.64	Professional	TC	$34.64	$34.64	$34.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.00 / $44.91 / $77.02	Professional		$36.00	$44.91	$77.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.56 / $17.39 / $27.20	Professional	26	$13.56	$17.39	$27.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.44 / $29.26 / $49.79	Professional	TC	$22.44	$29.26	$49.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $14.65	Facility	26	$14.65	$14.65	$14.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.33 / $51.81 / $82.68	Professional		$32.33	$51.81	$82.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.18 / $18.30 / $28.01	Professional	26	$11.18	$18.30	$28.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.63 / $35.11 / $57.49	Professional	TC	$21.63	$35.11	$57.49
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $30.22 / $100.00 / $100.00	Facility	26	$30.22	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.07 / $54.54 / $271.47	Professional		$39.07	$54.54	$271.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $18.41 / $94.11	Professional	26	$13.19	$18.41	$94.11
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.52 / $36.15 / $227.00	Professional	TC	$25.52	$36.15	$227.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $23.24 / $23.24 / $23.24	Professional	26	$23.24	$23.24	$23.24
United Facility/Professional Professional Modifier Low / Median / High Price $37.35 / $45.65 / $77.66	Professional		$37.35	$45.65	$77.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.91 / $15.74 / $26.05	Professional	26	$12.91	$15.74	$26.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.05 / $31.70 / $52.80	Professional	TC	$24.05	$31.70	$52.80