Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.48 / $8.96 / $16.82	Facility	26	$6.48	$8.96	$16.82
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $13.87 / $28.72 / $228.49	Facility	TC	$13.87	$28.72	$228.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.82 / $23.59 / $71.87	Professional		$18.82	$23.59	$71.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.48 / $7.82 / $34.27	Professional	26	$6.48	$7.82	$34.27
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $61.70 / $61.70 / $61.70	Professional	50	$61.70	$61.70	$61.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.99 / $16.37 / $51.61	Professional	TC	$11.99	$16.37	$51.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.74 / $35.74 / $35.74	Professional		$35.74	$35.74	$35.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.43 / $8.19 / $11.01	Professional	26	$5.43	$8.19	$11.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.67 / $26.52 / $45.59	Professional		$21.67	$26.52	$45.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.00 / $15.49	Professional	26	$7.94	$10.00	$15.49
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $32.50 / $39.78 / $68.38	Professional	50	$32.50	$39.78	$68.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.73 / $17.18 / $30.11	Professional	TC	$13.73	$17.18	$30.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $8.46 / $8.46	Facility	26	$8.46	$8.46	$8.46
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $16.03 / $16.03 / $16.03	Facility	TC	$16.03	$16.03	$16.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.09 / $29.85 / $46.61	Professional		$17.09	$29.85	$46.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.36 / $10.49 / $16.18	Professional	26	$6.36	$10.49	$16.18
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $31.05 / $31.05 / $31.05	Professional	50	$31.05	$31.05	$31.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.90 / $20.20 / $30.43	Professional	TC	$11.90	$20.20	$30.43
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $17.23 / $100.00 / $100.00	Facility	26	$17.23	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $30.15 / $100.00 / $100.00	Facility	TC	$30.15	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $21.01 / $29.79 / $172.00	Professional		$21.01	$29.79	$172.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.55 / $10.63 / $72.64	Professional	26	$7.55	$10.63	$72.64
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $13.20 / $19.48 / $148.00	Professional	TC	$13.20	$19.48	$148.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $13.31 / $13.31 / $13.31	Professional	26	$13.31	$13.31	$13.31
United Facility/Professional Professional Modifier Low / Median / High Price $19.87 / $25.97 / $41.83	Professional		$19.87	$25.97	$41.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.39 / $8.94 / $14.94	Professional	26	$7.39	$8.94	$14.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $17.10 / $27.14	Professional	TC	$12.88	$17.10	$27.14