Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $12.87 / $20.03	Facility	26	$10.36	$12.87	$20.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.15 / $42.08 / $181.12	Professional		$34.15	$42.08	$181.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $13.96 / $51.37	Professional	26	$9.44	$13.96	$51.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.51 / $28.34 / $83.12	Professional	TC	$24.51	$28.34	$83.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.03 / $31.21 / $36.67	Professional		$28.03	$31.21	$36.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.17 / $11.20 / $16.04	Professional	26	$8.17	$11.20	$16.04
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.93 / $24.27 / $41.58	Professional	TC	$23.93	$24.27	$41.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.90 / $41.84 / $75.45	Professional		$32.90	$41.84	$75.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.77 / $14.03 / $22.79	Professional	26	$10.77	$14.03	$22.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.13 / $28.84 / $53.42	Professional	TC	$22.13	$28.84	$53.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.85 / $50.49 / $76.77	Professional		$29.85	$50.49	$76.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $14.93 / $23.58	Professional	26	$9.33	$14.93	$23.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.63 / $35.63 / $56.07	Professional	TC	$21.63	$35.63	$56.07
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $25.47 / $100.00 / $100.00	Facility	26	$25.47	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.03 / $50.31 / $252.05	Professional		$37.03	$50.31	$252.05
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.90 / $15.62 / $92.47	Professional	26	$10.90	$15.62	$92.47
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.25 / $35.22 / $226.00	Professional	TC	$25.25	$35.22	$226.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $19.55 / $19.55 / $19.55	Professional	26	$19.55	$19.55	$19.55
United Facility/Professional Professional Modifier Low / Median / High Price $35.08 / $42.90 / $72.19	Professional		$35.08	$42.90	$72.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.90 / $13.61 / $22.73	Professional	26	$10.90	$13.61	$22.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.58 / $29.92 / $49.68	Professional	TC	$24.58	$29.92	$49.68