Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $14.79 / $24.55	Facility	26	$10.00	$14.79	$24.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $46.77 / $194.98	Professional		$30.90	$46.77	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.79 / $37.15	Professional	26	$8.91	$14.79	$37.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $32.36 / $85.11	Professional	TC	$21.88	$32.36	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $51.29 / $53.70	Professional		$29.51	$51.29	$53.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $12.30 / $17.78	Professional	26	$8.13	$12.30	$17.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $23.99 / $48.98	Professional	TC	$23.99	$23.99	$48.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $47.86 / $85.11	Professional		$38.90	$47.86	$85.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $13.80 / $22.39	Professional	26	$10.96	$13.80	$22.39
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $34.67 / $57.54	Professional	TC	$27.54	$34.67	$57.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $45.71 / $67.61	Professional		$43.65	$45.71	$67.61
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $12.30 / $18.20	Professional	26	$11.48	$12.30	$18.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $33.88 / $48.98	Professional	TC	$32.36	$33.88	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $53.70 / $93.33	Professional		$33.88	$53.70	$93.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $15.14 / $27.54	Professional	26	$9.55	$15.14	$27.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $39.81 / $72.44	Professional	TC	$25.70	$39.81	$72.44
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $100.00 / $100.00	Facility	26	$25.12	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $56.23 / $263.03	Professional		$38.02	$56.23	$263.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $15.85 / $117.49	Professional	26	$10.72	$15.85	$117.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $40.74 / $199.53	Professional	TC	$25.70	$40.74	$199.53
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $63.10 / $69.18	Professional		$58.88	$63.10	$69.18
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $19.95 / $19.95	Professional	26	$19.95	$19.95	$19.95
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $45.71 / $45.71	Professional	TC	$45.71	$45.71	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $46.77 / $75.86	Professional		$36.31	$46.77	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.30 / $21.38	Professional	26	$10.47	$12.30	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.88 / $54.95	Professional	TC	$25.70	$33.88	$54.95