Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $12.88 / $24.55	Facility	26	$10.47	$12.88	$24.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $45.71 / $181.97	Professional		$30.90	$45.71	$181.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $16.22 / $35.48	Professional	26	$8.91	$16.22	$35.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.90 / $69.18	Professional	TC	$21.88	$30.90	$69.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $32.36 / $60.26	Professional		$30.90	$32.36	$60.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.00 / $16.60	Professional	26	$7.94	$10.00	$16.60
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $23.99 / $36.31	Professional	TC	$19.50	$23.99	$36.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $38.90 / $67.61	Professional		$31.62	$38.90	$67.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $11.75 / $20.42	Professional	26	$9.33	$11.75	$20.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.18 / $48.98	Professional	TC	$21.88	$28.18	$48.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $42.66 / $57.54	Professional		$40.74	$42.66	$57.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $11.75 / $16.60	Professional	26	$11.22	$11.75	$16.60
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $30.90 / $41.69	Professional	TC	$29.51	$30.90	$41.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $45.71 / $85.11	Professional		$29.51	$45.71	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $13.18 / $24.55	Professional	26	$8.71	$13.18	$24.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $33.11 / $61.66	Professional	TC	$21.38	$33.11	$61.66
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $100.00 / $100.00	Facility	26	$25.70	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $51.29 / $251.19	Professional		$33.11	$51.29	$251.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $15.14 / $97.72	Professional	26	$9.77	$15.14	$97.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $35.48 / $181.97	Professional	TC	$22.91	$35.48	$181.97
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $19.50 / $19.50	Professional	26	$19.50	$19.50	$19.50
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $47.86 / $47.86	Professional	TC	$47.86	$47.86	$47.86
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $40.74 / $66.07	Professional		$33.11	$40.74	$66.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.02 / $20.42	Professional	26	$9.55	$12.02	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $28.18 / $46.77	Professional	TC	$22.91	$28.18	$46.77