Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.21 / $16.25 / $29.19	Facility	26	$11.21	$16.25	$29.19
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.47 / $44.86 / $412.08	Facility	TC	$28.47	$44.86	$412.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.65 / $41.00 / $212.00	Professional		$35.65	$41.00	$212.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.21 / $12.69 / $30.85	Professional	26	$11.21	$12.69	$30.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.56 / $28.47 / $62.00	Professional	TC	$24.56	$28.47	$62.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.92 / $33.92 / $39.78	Professional		$33.92	$33.92	$39.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.46 / $9.47 / $20.21	Professional	26	$9.46	$9.47	$20.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.61 / $44.57 / $70.64	Professional		$36.61	$44.57	$70.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.56 / $15.79 / $24.22	Professional	26	$13.56	$15.79	$24.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.06 / $28.73 / $48.80	Professional	TC	$23.06	$28.73	$48.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $14.65	Facility	26	$14.65	$14.65	$14.65
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $33.92 / $33.92 / $33.92	Facility	TC	$33.92	$33.92	$33.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.33 / $52.64 / $83.98	Professional		$32.33	$52.64	$83.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.20 / $18.36 / $29.81	Professional	26	$11.20	$18.36	$29.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.86 / $34.19 / $58.91	Professional	TC	$21.86	$34.19	$58.91
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $30.22 / $70.00 / $70.00	Facility	26	$30.22	$70.00	$70.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $42.05 / $136.22 / $136.22	Facility	TC	$42.05	$136.22	$136.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.99 / $50.03 / $277.95	Professional		$37.99	$50.03	$277.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.03 / $16.78 / $81.06	Professional	26	$13.03	$16.78	$81.06
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.26 / $31.96 / $196.89	Professional	TC	$24.26	$31.96	$196.89
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $23.24 / $23.24 / $23.24	Professional	26	$23.24	$23.24	$23.24
United Facility/Professional Professional Modifier Low / Median / High Price $37.99 / $46.48 / $80.22	Professional		$37.99	$46.48	$80.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.91 / $16.00 / $25.75	Professional	26	$12.91	$16.00	$25.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.23 / $30.04 / $52.81	Professional	TC	$24.23	$30.04	$52.81