Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.00 / $45.50 / $81.51	Facility	26	$35.00	$45.50	$81.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.25 / $112.25 / $483.00	Professional		$73.25	$112.25	$483.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.86 / $49.17 / $208.00	Professional	26	$31.86	$49.17	$208.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.39 / $51.14 / $181.00	Professional	TC	$41.39	$51.14	$181.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.13 / $81.23 / $120.18	Professional		$64.13	$81.23	$120.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.00 / $40.29 / $54.10	Professional	26	$27.00	$40.29	$54.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $38.15 / $38.15 / $76.42	Professional	TC	$38.15	$38.15	$76.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.51 / $101.19 / $165.04	Professional		$82.51	$101.19	$165.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.92 / $47.88 / $72.42	Professional	26	$38.92	$47.88	$72.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.59 / $54.96 / $95.63	Professional	TC	$43.59	$54.96	$95.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.65 / $41.65 / $41.65	Facility	26	$41.65	$41.65	$41.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.00 / $112.05 / $182.60	Professional		$69.00	$112.05	$182.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.18 / $48.61 / $89.66	Professional	26	$31.18	$48.61	$89.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.79 / $64.03 / $102.51	Professional	TC	$39.79	$64.03	$102.51
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $86.18 / $163.47 / $163.47	Facility	26	$86.18	$163.47	$163.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $84.31 / $112.44 / $555.44	Professional		$84.31	$112.44	$555.44
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $37.03 / $48.61 / $269.13	Professional	26	$37.03	$48.61	$269.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $48.42 / $63.46 / $351.46	Professional	TC	$48.42	$63.46	$351.46
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $66.26 / $66.26 / $66.26	Professional	26	$66.26	$66.26	$66.26
United Facility/Professional Professional Modifier Low / Median / High Price $81.61 / $97.26 / $159.55	Professional		$81.61	$97.26	$159.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.40 / $43.27 / $71.83	Professional	26	$35.40	$43.27	$71.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.13 / $55.01 / $94.74	Professional	TC	$45.13	$55.01	$94.74