Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.73 / $11.52 / $20.58	Facility	26	$8.73	$11.52	$20.58
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.44 / $166.38 / $242.53	Facility	TC	$23.44	$166.38	$242.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.90 / $32.04 / $135.00	Professional		$21.90	$32.04	$135.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $9.55 / $40.79	Professional	26	$7.95	$9.55	$40.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $22.53 / $52.75	Professional	TC	$18.32	$22.53	$52.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.69 / $9.43 / $13.51	Professional	26	$6.69	$9.43	$13.51
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $35.29 / $35.29 / $35.29	Professional	TC	$35.29	$35.29	$35.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.04 / $34.54 / $59.47	Professional		$28.04	$34.54	$59.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $11.51 / $19.48	Professional	26	$9.33	$11.51	$19.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.71 / $23.40 / $39.68	Professional	TC	$18.71	$23.40	$39.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.15 / $27.15 / $27.15	Facility	TC	$27.15	$27.15	$27.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.88 / $39.65 / $64.45	Professional		$24.88	$39.65	$64.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.84 / $12.88 / $19.86	Professional	26	$7.84	$12.88	$19.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.26 / $26.71 / $47.69	Professional	TC	$17.26	$26.71	$47.69
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $21.10 / $70.00 / $70.00	Facility	26	$21.10	$70.00	$70.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $51.52 / $110.49 / $110.49	Facility	TC	$51.52	$110.49	$110.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.62 / $38.54 / $208.77	Professional		$28.62	$38.54	$208.77
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.25 / $11.69 / $57.45	Professional	26	$9.25	$11.69	$57.45
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $25.08 / $151.32	Professional	TC	$19.14	$25.08	$151.32
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $16.34 / $16.34 / $16.34	Professional	26	$16.34	$16.34	$16.34
United Facility/Professional Professional Modifier Low / Median / High Price $28.32 / $35.33 / $60.52	Professional		$28.32	$35.33	$60.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.25 / $11.14 / $17.85	Professional	26	$9.25	$11.14	$17.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.02 / $25.00 / $42.00	Professional	TC	$19.02	$25.00	$42.00