Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.03 / $23.72 / $39.02	Facility	26	$15.03	$23.72	$39.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.46 / $74.70 / $149.71	Professional		$63.46	$74.70	$149.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.02 / $16.95 / $45.31	Professional	26	$15.02	$16.95	$45.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.62 / $56.75 / $109.31	Professional	TC	$48.62	$56.75	$109.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.00 / $105.00 / $105.00	Professional		$105.00	$105.00	$105.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.09 / $16.50 / $18.96	Professional	26	$13.09	$16.50	$18.96
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $52.59 / $52.59 / $52.59	Professional	TC	$52.59	$52.59	$52.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.05 / $83.09 / $135.83	Professional		$69.05	$83.09	$135.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.98 / $21.45 / $36.65	Professional	26	$17.98	$21.45	$36.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.05 / $60.44 / $99.75	Professional	TC	$51.05	$60.44	$99.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $19.60 / $19.60	Facility	26	$19.60	$19.60	$19.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.14 / $91.21 / $156.62	Professional		$59.14	$91.21	$156.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.67 / $23.99 / $37.60	Professional	26	$14.67	$23.99	$37.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.46 / $67.67 / $122.44	Professional	TC	$44.46	$67.67	$122.44
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $40.36 / $77.22 / $77.22	Facility	26	$40.36	$77.22	$77.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.00 / $89.87 / $507.76	Professional		$68.00	$89.87	$507.76
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.57 / $21.79 / $109.02	Professional	26	$17.57	$21.79	$109.02
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $50.67 / $68.37 / $398.67	Professional	TC	$50.67	$68.37	$398.67
United Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $85.16 / $148.74	Professional		$67.55	$85.16	$148.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.46 / $21.14 / $34.60	Professional	26	$17.46	$21.14	$34.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.30 / $64.69 / $113.82	Professional	TC	$50.30	$64.69	$113.82