Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.69 / $28.12 / $48.94	Facility	26	$22.69	$28.12	$48.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.49 / $82.34 / $321.32	Professional		$42.49	$82.34	$321.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.97 / $26.92 / $79.50	Professional	26	$16.97	$26.92	$79.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.83 / $32.58 / $163.10	Professional	TC	$21.83	$32.58	$163.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.10 / $43.25 / $70.28	Professional		$36.10	$43.25	$70.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.44 / $23.75 / $37.93	Professional	26	$17.44	$23.75	$37.93
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.27 / $22.27 / $22.27	Professional	TC	$22.27	$22.27	$22.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.58 / $56.06 / $144.11	Professional		$45.58	$56.06	$144.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.69 / $28.93 / $40.42	Professional	26	$24.69	$28.93	$40.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $26.51 / $108.15	Professional	TC	$20.89	$26.51	$108.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.65 / $26.65 / $26.65	Facility	26	$26.65	$26.65	$26.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.85 / $69.62 / $151.00	Professional		$39.85	$69.62	$151.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.71 / $27.23 / $50.87	Professional	26	$17.71	$27.23	$50.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $37.47 / $116.56	Professional	TC	$19.80	$37.47	$116.56
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $55.69 / $115.00 / $115.00	Facility	26	$55.69	$115.00	$115.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.01 / $91.84 / $575.66	Professional		$49.01	$91.84	$575.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.46 / $29.99 / $232.81	Professional	26	$19.46	$29.99	$232.81
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.41 / $55.30 / $398.91	Professional	TC	$23.41	$55.30	$398.91
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $42.80 / $42.80 / $42.80	Professional	26	$42.80	$42.80	$42.80
United Facility/Professional Professional Modifier Low / Median / High Price $45.48 / $59.33 / $108.93	Professional		$45.48	$59.33	$108.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.46 / $27.79 / $45.21	Professional	26	$19.46	$27.79	$45.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.49 / $29.82 / $79.75	Professional	TC	$22.49	$29.82	$79.75