Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.56 / $20.38 / $34.43	Facility	26	$14.56	$20.38	$34.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.83 / $69.33 / $296.00	Professional		$57.83	$69.33	$296.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.42 / $21.33 / $67.81	Professional	26	$13.42	$21.33	$67.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.02 / $52.28 / $126.48	Professional	TC	$45.02	$52.28	$126.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.90 / $40.90 / $52.22	Professional		$39.90	$40.90	$52.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.11 / $18.85 / $23.70	Professional	26	$11.11	$18.85	$23.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $80.22 / $80.22 / $80.22	Professional	TC	$80.22	$80.22	$80.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.59 / $72.47 / $125.07	Professional		$58.59	$72.47	$125.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.93 / $19.64 / $32.61	Professional	26	$15.93	$19.64	$32.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $53.38 / $91.37	Professional	TC	$42.66	$53.38	$91.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $17.32	Facility	26	$17.32	$17.32	$17.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.40 / $83.41 / $137.28	Professional		$52.40	$83.41	$137.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.24 / $21.67 / $33.54	Professional	26	$13.24	$21.67	$33.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.65 / $61.58 / $108.92	Professional	TC	$39.65	$61.58	$108.92
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $35.32 / $70.00 / $70.00	Facility	26	$35.32	$70.00	$70.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.22 / $81.73 / $453.03	Professional		$60.22	$81.73	$453.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.77 / $19.84 / $95.54	Professional	26	$15.77	$19.84	$95.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $44.17 / $58.25 / $357.49	Professional	TC	$44.17	$58.25	$357.49
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $27.26 / $27.26 / $27.26	Professional	26	$27.26	$27.26	$27.26
United Facility/Professional Professional Modifier Low / Median / High Price $60.22 / $75.23 / $130.28	Professional		$60.22	$75.23	$130.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.77 / $19.28 / $31.54	Professional	26	$15.77	$19.28	$31.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.05 / $55.34 / $96.24	Professional	TC	$44.05	$55.34	$96.24