Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.63 / $18.78 / $27.56	Facility	26	$12.63	$18.78	$27.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.27 / $61.27 / $195.00	Professional		$46.27	$61.27	$195.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.56 / $17.72 / $62.64	Professional	26	$11.56	$17.72	$62.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.61 / $40.61 / $100.06	Professional	TC	$33.61	$40.61	$100.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.54 / $46.15 / $68.73	Professional		$30.54	$46.15	$68.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.68 / $13.63 / $20.69	Professional	26	$9.68	$13.63	$20.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.21 / $43.99 / $59.45	Professional	TC	$34.21	$43.99	$59.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.84 / $59.33 / $101.77	Professional		$45.84	$59.33	$101.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.62 / $19.28 / $31.59	Professional	26	$15.62	$19.28	$31.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.22 / $39.72 / $70.17	Professional	TC	$30.22	$39.72	$70.17
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 $40.44 / $66.66 / $105.06	Professional		$40.44	$66.66	$105.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.68 / $19.43 / $30.90	Professional	26	$11.68	$19.43	$30.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.24 / $47.15 / $80.56	Professional	TC	$29.24	$47.15	$80.56
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $30.85 / $110.00 / $110.00	Facility	26	$30.85	$110.00	$110.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.69 / $68.34 / $343.08	Professional		$48.69	$68.34	$343.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.86 / $19.62 / $113.92	Professional	26	$13.86	$19.62	$113.92
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $33.56 / $48.34 / $259.85	Professional	TC	$33.56	$48.34	$259.85
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $91.66 / $91.66 / $91.66	Professional		$91.66	$91.66	$91.66
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $21.39 / $23.79 / $23.79	Professional	26	$21.39	$23.79	$23.79
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $65.15 / $65.15 / $65.15	Professional	TC	$65.15	$65.15	$65.15
United Facility/Professional Professional Modifier Low / Median / High Price $46.13 / $57.27 / $97.38	Professional		$46.13	$57.27	$97.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.37 / $17.17 / $29.76	Professional	26	$13.37	$17.17	$29.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.60 / $42.10 / $68.84	Professional	TC	$31.60	$42.10	$68.84