Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $15.85 / $29.51	Facility	26	$12.02	$15.85	$29.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $70.79 / $229.09	Professional		$41.69	$70.79	$229.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $19.95 / $58.88	Professional	26	$10.96	$19.95	$58.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $50.12 / $89.13	Professional	TC	$30.90	$50.12	$89.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $39.81 / $74.13	Professional		$33.11	$39.81	$74.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $12.30 / $20.42	Professional	26	$9.33	$12.30	$20.42
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $39.81 / $60.26	Professional	TC	$30.20	$39.81	$60.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $57.54 / $97.72	Professional		$46.77	$57.54	$97.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $19.05 / $29.51	Professional	26	$15.49	$19.05	$29.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $38.90 / $69.18	Professional	TC	$30.90	$38.90	$69.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $58.88 / $75.86	Professional		$56.23	$58.88	$75.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $15.49 / $22.39	Professional	26	$13.80	$15.49	$22.39
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $43.65 / $57.54	Professional	TC	$40.74	$43.65	$57.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $63.10 / $114.82	Professional		$42.66	$63.10	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $18.62 / $36.31	Professional	26	$11.75	$18.62	$36.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $46.77 / $85.11	Professional	TC	$30.20	$46.77	$85.11
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $109.65 / $109.65	Facility	26	$30.20	$109.65	$109.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $67.61 / $331.13	Professional		$45.71	$67.61	$331.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $19.50 / $120.23	Professional	26	$12.88	$19.50	$120.23
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $47.86 / $295.12	Professional	TC	$31.62	$47.86	$295.12
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $87.10 / $93.33	Professional		$79.43	$87.10	$93.33
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $22.91 / $23.44	Professional	26	$22.91	$22.91	$23.44
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $58.88 / $69.18	Professional	TC	$58.88	$58.88	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $56.23 / $91.20	Professional		$44.67	$56.23	$91.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $15.85 / $25.70	Professional	26	$12.30	$15.85	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $39.81 / $66.07	Professional	TC	$31.62	$39.81	$66.07