Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.27 / $19.13 / $31.48	Facility	26	$13.27	$19.13	$31.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.29 / $43.05 / $216.00	Professional		$37.29	$43.05	$216.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.08 / $13.69 / $53.81	Professional	26	$12.08	$13.69	$53.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.14 / $28.95 / $88.39	Professional	TC	$25.14	$28.95	$88.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.70 / $64.93 / $72.22	Professional		$34.70	$64.93	$72.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.56 / $17.17 / $21.44	Professional	26	$10.56	$17.17	$21.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.04 / $25.04 / $25.04	Professional	TC	$25.04	$25.04	$25.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.60 / $46.69 / $79.91	Professional		$37.60	$46.69	$79.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.54 / $17.80 / $27.20	Professional	26	$14.54	$17.80	$27.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.06 / $30.34 / $52.66	Professional	TC	$23.06	$30.34	$52.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.80 / $15.80 / $15.80	Facility	26	$15.80	$15.80	$15.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.42 / $55.65 / $85.96	Professional		$33.42	$55.65	$85.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.20 / $18.72 / $30.23	Professional	26	$11.20	$18.72	$30.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.11 / $37.13 / $58.91	Professional	TC	$22.11	$37.13	$58.91
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $32.60 / $100.00 / $100.00	Facility	26	$32.60	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.12 / $56.42 / $282.23	Professional		$41.12	$56.42	$282.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.69 / $20.30 / $100.72	Professional	26	$13.69	$20.30	$100.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.72 / $37.09 / $254.00	Professional	TC	$26.72	$37.09	$254.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $74.67 / $74.67 / $74.67	Professional		$74.67	$74.67	$74.67
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $25.08 / $25.08 / $25.08	Professional	26	$25.08	$25.08	$25.08
United Facility/Professional Professional Modifier Low / Median / High Price $38.59 / $49.98 / $84.41	Professional		$38.59	$49.98	$84.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $16.95 / $27.75	Professional	26	$13.49	$16.95	$27.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $31.66 / $52.90	Professional	TC	$25.12	$31.66	$52.90