Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $19.95 / $31.62	Facility	26	$12.88	$19.95	$31.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $45.71 / $177.83	Professional		$32.36	$45.71	$177.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.98 / $53.70	Professional	26	$10.96	$16.98	$53.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.20 / $72.44	Professional	TC	$21.88	$30.20	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $74.13	Professional		$35.48	$35.48	$74.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $12.88 / $22.91	Professional	26	$10.23	$12.88	$22.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $19.95 / $29.51	Professional	TC	$19.95	$19.95	$29.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $46.77 / $81.28	Professional		$38.02	$46.77	$81.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $16.98 / $26.92	Professional	26	$14.45	$16.98	$26.92
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 $44.67 / $46.77 / $67.61	Professional		$44.67	$46.77	$67.61
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $15.14 / $22.91	Professional	26	$14.45	$15.14	$22.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $31.62 / $41.69	Professional	TC	$30.20	$31.62	$41.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $52.48 / $95.50	Professional		$33.88	$52.48	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $18.20 / $34.67	Professional	26	$11.75	$18.20	$34.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $36.31 / $67.61	Professional	TC	$22.91	$36.31	$67.61
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $100.00 / $100.00	Facility	26	$32.36	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $56.23 / $281.84	Professional		$38.02	$56.23	$281.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $20.42 / $100.00	Professional	26	$13.49	$20.42	$100.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $38.90 / $251.19	Professional	TC	$23.99	$38.90	$251.19
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Professional		$74.13	$74.13	$74.13
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $25.12 / $25.12	Professional	26	$25.12	$25.12	$25.12
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $46.77 / $74.13	Professional		$37.15	$46.77	$74.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $15.85 / $26.30	Professional	26	$13.18	$15.85	$26.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $30.90 / $50.12	Professional	TC	$23.99	$30.90	$50.12