Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.68 / $11.83 / $20.60	Facility	26	$10.68	$11.83	$20.60
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.39 / $275.19 / $369.24	Facility	TC	$24.39	$275.19	$369.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.36 / $36.18 / $180.00	Professional		$31.36	$36.18	$180.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.73 / $14.99 / $48.64	Professional	26	$9.73	$14.99	$48.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.76 / $24.85 / $122.00	Professional	TC	$20.76	$24.85	$122.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.39 / $27.63 / $29.97	Professional		$26.39	$27.63	$29.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.19 / $11.28 / $18.14	Professional	26	$8.19	$11.28	$18.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.71 / $21.71 / $21.71	Professional	TC	$21.71	$21.71	$21.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.71 / $39.22 / $60.48	Professional		$31.71	$39.22	$60.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.45 / $14.14 / $21.45	Professional	26	$11.45	$14.14	$21.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.05 / $25.09 / $41.81	Professional	TC	$20.05	$25.09	$41.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.36 / $45.00 / $77.58	Professional		$28.36	$45.00	$77.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $15.80 / $25.85	Professional	26	$9.44	$15.80	$25.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.79 / $29.43 / $50.92	Professional	TC	$18.79	$29.43	$50.92
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $26.10 / $70.00 / $70.00	Facility	26	$26.10	$70.00	$70.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $52.00 / $118.08 / $118.08	Facility	TC	$52.00	$118.08	$118.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.44 / $43.54 / $236.84	Professional		$32.44	$43.54	$236.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $14.29 / $70.37	Professional	26	$11.32	$14.29	$70.37
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.86 / $27.74 / $166.53	Professional	TC	$20.86	$27.74	$166.53
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $20.11 / $20.11 / $20.11	Professional	26	$20.11	$20.11	$20.11
United Facility/Professional Professional Modifier Low / Median / High Price $32.44 / $39.44 / $68.18	Professional		$32.44	$39.44	$68.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.09 / $13.67 / $22.33	Professional	26	$11.09	$13.67	$22.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.85 / $25.79 / $47.39	Professional	TC	$20.85	$25.79	$47.39