Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.79 / $11.59 / $21.51	Facility	26	$10.79	$11.59	$21.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.72 / $73.34 / $327.00	Professional		$24.72	$73.34	$327.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $10.79 / $54.00	Professional	26	$9.27	$10.79	$54.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.68 / $25.40 / $177.86	Professional	TC	$14.68	$25.40	$177.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.84 / $20.44 / $38.24	Professional		$17.84	$20.44	$38.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.96 / $9.08 / $13.10	Professional	26	$6.96	$9.08	$13.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.65 / $23.39 / $23.39	Professional	TC	$13.65	$23.39	$23.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.30 / $29.25 / $156.44	Professional		$21.30	$29.25	$156.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.74 / $12.00 / $21.06	Professional	26	$9.74	$12.00	$21.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $11.55 / $16.04 / $134.33	Professional	TC	$11.55	$16.04	$134.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $5.59 / $5.59 / $5.59	Facility	53	$5.59	$5.59	$5.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.47 / $40.19 / $159.91	Professional		$19.47	$40.19	$159.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.25 / $13.53 / $20.63	Professional	26	$8.25	$13.53	$20.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.82 / $23.48 / $143.07	Professional	TC	$11.82	$23.48	$143.07
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $58.20 / $132.00 / $132.00	Facility	26	$58.20	$132.00	$132.00
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $10.91 / $53.18 / $53.18	Facility	53	$10.91	$53.18	$53.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.46 / $56.73 / $761.56	Professional		$23.46	$56.73	$761.56
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.01 / $13.16 / $132.00	Professional	26	$10.01	$13.16	$132.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $13.35 / $28.03 / $705.08	Professional	TC	$13.35	$28.03	$705.08
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $43.98 / $43.98 / $43.98	Professional		$43.98	$43.98	$43.98
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $17.07 / $17.07	Professional	26	$17.07	$17.07	$17.07
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $26.90 / $26.90 / $26.90	Professional	TC	$26.90	$26.90	$26.90
United Facility/Professional Professional Modifier Low / Median / High Price $22.80 / $32.84 / $126.87	Professional		$22.80	$32.84	$126.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.61 / $12.13 / $21.87	Professional	26	$9.61	$12.13	$21.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.01 / $18.78 / $89.02	Professional	TC	$12.01	$18.78	$89.02