Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $15.85 / $29.51	Facility	26	$12.30	$15.85	$29.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $44.67 / $154.88	Professional		$19.50	$44.67	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $18.62 / $46.77	Professional	26	$10.96	$18.62	$46.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $35.48 / $77.62	Professional	TC	$22.91	$35.48	$77.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $32.36 / $57.54	Professional		$25.70	$32.36	$57.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $13.80 / $20.42	Professional	26	$9.55	$13.80	$20.42
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $23.44 / $28.18	Professional	TC	$18.62	$23.44	$28.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $44.67 / $74.13	Professional		$36.31	$44.67	$74.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $16.98 / $26.30	Professional	26	$13.49	$16.98	$26.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $28.84 / $50.12	Professional	TC	$22.39	$28.84	$50.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $45.71 / $66.07	Professional		$43.65	$45.71	$66.07
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $14.13 / $21.38	Professional	26	$13.80	$14.13	$21.38
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $31.62 / $44.67	Professional	TC	$30.20	$31.62	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $50.12 / $91.20	Professional		$33.11	$50.12	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $17.78 / $33.11	Professional	26	$11.22	$17.78	$33.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $34.67 / $64.57	Professional	TC	$21.88	$34.67	$64.57
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $100.00 / $100.00	Facility	26	$30.20	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $56.23 / $269.15	Professional		$37.15	$56.23	$269.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $18.62 / $93.33	Professional	26	$12.88	$18.62	$93.33
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $37.15 / $229.09	Professional	TC	$23.44	$37.15	$229.09
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $72.44	Professional		$61.66	$61.66	$72.44
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $23.44 / $23.44	Professional	26	$23.44	$23.44	$23.44
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $41.69 / $48.98	Professional	TC	$41.69	$41.69	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $44.67 / $72.44	Professional		$36.31	$44.67	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $15.14 / $25.12	Professional	26	$12.30	$15.14	$25.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $28.84 / $47.86	Professional	TC	$23.44	$28.84	$47.86