Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $12.88 / $24.55	Facility	26	$10.47	$12.88	$24.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $48.98 / $169.82	Professional		$32.36	$48.98	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $16.22 / $44.67	Professional	26	$8.91	$16.22	$44.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.88 / $77.62	Professional	TC	$21.88	$33.88	$77.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $30.90 / $58.88	Professional		$22.91	$30.90	$58.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.47 / $16.98	Professional	26	$7.94	$10.47	$16.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $24.55 / $47.86	Professional	TC	$18.20	$24.55	$47.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $41.69 / $74.13	Professional		$33.11	$41.69	$74.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $13.49 / $21.88	Professional	26	$10.72	$13.49	$21.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.84 / $54.95	Professional	TC	$21.88	$28.84	$54.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $42.66 / $61.66	Professional		$40.74	$42.66	$61.66
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $11.75 / $17.78	Professional	26	$11.22	$11.75	$17.78
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $30.90 / $39.81	Professional	TC	$29.51	$30.90	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $47.86 / $85.11	Professional		$30.20	$47.86	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $14.79 / $26.92	Professional	26	$9.33	$14.79	$26.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $34.67 / $64.57	Professional	TC	$22.39	$34.67	$64.57
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $100.00 / $100.00	Facility	26	$25.70	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $50.12 / $251.19	Professional		$34.67	$50.12	$251.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $15.49 / $93.33	Professional	26	$10.72	$15.49	$93.33
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $36.31 / $223.87	Professional	TC	$23.44	$36.31	$223.87
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $67.61	Professional		$57.54	$57.54	$67.61
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $16.60 / $19.50	Professional	26	$16.60	$16.60	$19.50
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $47.86 / $47.86	Professional	TC	$40.74	$47.86	$47.86
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $42.66 / $67.61	Professional		$33.88	$42.66	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $12.30 / $20.42	Professional	26	$10.23	$12.30	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $29.51 / $48.98	Professional	TC	$23.44	$29.51	$48.98