Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $14.45 / $23.44	Facility	26	$9.77	$14.45	$23.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $40.74 / $165.96	Professional		$28.18	$40.74	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $13.18 / $33.88	Professional	26	$7.94	$13.18	$33.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.70 / $60.26	Professional	TC	$19.05	$25.70	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $27.54 / $58.88	Professional		$21.88	$27.54	$58.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $11.22 / $16.60	Professional	26	$7.41	$11.22	$16.60
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $26.92 / $67.61	Professional	TC	$26.92	$26.92	$67.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $38.02 / $64.57	Professional		$30.90	$38.02	$64.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $13.49 / $21.88	Professional	26	$10.96	$13.49	$21.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $25.70 / $44.67	Professional	TC	$19.50	$25.70	$44.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $38.02 / $53.70	Professional		$37.15	$38.02	$53.70
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $11.22 / $16.98	Professional	26	$10.96	$11.22	$16.98
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $26.92 / $38.90	Professional	TC	$25.70	$26.92	$38.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $44.67 / $75.86	Professional		$27.54	$44.67	$75.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $14.45 / $26.30	Professional	26	$9.33	$14.45	$26.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $31.62 / $57.54	Professional	TC	$19.50	$31.62	$57.54
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $100.00 / $100.00	Facility	26	$23.99	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $46.77 / $223.87	Professional		$31.62	$46.77	$223.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $15.14 / $93.33	Professional	26	$10.72	$15.14	$93.33
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $31.62 / $208.93	Professional	TC	$20.89	$31.62	$208.93
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Professional		$50.12	$50.12	$50.12
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $18.20 / $18.62	Professional	26	$18.20	$18.20	$18.62
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $38.02 / $61.66	Professional		$30.90	$38.02	$61.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.30 / $20.42	Professional	26	$10.00	$12.30	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $25.70 / $43.65	Professional	TC	$20.42	$25.70	$43.65