Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.71 / $13.18 / $20.89	Facility	26	$8.71	$13.18	$20.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $34.67 / $120.23	Professional		$22.91	$34.67	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.23 / $41.69	Professional	26	$7.08	$10.23	$41.69
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $30.20 / $33.88 / $54.95	Professional	52	$30.20	$33.88	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $20.89 / $66.07	Professional	TC	$15.14	$20.89	$66.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $21.88 / $44.67	Professional		$19.95	$21.88	$44.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $7.24 / $8.71	Professional	26	$7.24	$7.24	$8.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $40.74 / $63.10	Professional		$33.88	$40.74	$63.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.88 / $19.95	Professional	26	$10.47	$12.88	$19.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $27.54 / $39.81	Professional	TC	$23.44	$27.54	$39.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $33.11 / $51.29	Professional		$31.62	$33.11	$51.29
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $10.47 / $15.85	Professional	26	$10.00	$10.47	$15.85
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $22.91 / $36.31	Professional	TC	$21.88	$22.91	$36.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $41.69 / $74.13	Professional		$25.12	$41.69	$74.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $12.88 / $24.55	Professional	26	$8.51	$12.88	$24.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $30.20 / $53.70	Professional	TC	$17.38	$30.20	$53.70
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $100.00 / $100.00	Facility	26	$20.89	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $45.71 / $213.80	Professional		$30.20	$45.71	$213.80
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $13.80 / $79.43	Professional	26	$9.33	$13.80	$79.43
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $31.62 / $204.17	Professional	TC	$19.95	$31.62	$204.17
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $16.98 / $16.98	Professional	26	$16.98	$16.98	$16.98
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $38.02 / $60.26	Professional		$28.84	$38.02	$60.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $11.22 / $18.62	Professional	26	$8.71	$11.22	$18.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $26.30 / $42.66	Professional	TC	$19.95	$26.30	$42.66