Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.73 / $36.63 / $47.60	Facility	26	$31.73	$36.63	$47.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.64 / $57.61 / $187.00	Professional		$28.64	$57.61	$187.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.21 / $35.11 / $84.96	Professional	26	$18.21	$35.11	$84.96
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.10 / $35.97 / $35.97	Professional	50	$35.10	$35.97	$35.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.03 / $11.21 / $60.00	Professional	TC	$8.03	$11.21	$60.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.57 / $52.40 / $95.03	Professional		$45.57	$52.40	$95.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.42 / $33.49 / $49.11	Professional	26	$24.42	$33.49	$49.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.60 / $17.60 / $46.64	Professional	TC	$17.60	$17.60	$46.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.07 / $55.02 / $78.81	Professional		$38.07	$55.02	$78.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.33 / $28.30 / $43.28	Professional	26	$24.33	$28.30	$43.28
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $57.10 / $82.53 / $118.23	Professional	50	$57.10	$82.53	$118.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.64 / $28.66 / $40.03	Professional	TC	$9.64	$28.66	$40.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.43 / $37.43 / $37.43	Facility	26	$37.43	$37.43	$37.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.04 / $50.90 / $102.44	Professional		$35.04	$50.90	$102.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.31 / $32.59 / $54.26	Professional	26	$21.31	$32.59	$54.26
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $74.87 / $74.87 / $74.87	Professional	50	$74.87	$74.87	$74.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.13 / $22.11 / $54.99	Professional	TC	$10.13	$22.11	$54.99
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $77.38 / $148.36 / $148.36	Facility	26	$77.38	$148.36	$148.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.94 / $60.67 / $359.16	Professional		$32.94	$60.67	$359.16
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.05 / $29.19 / $197.46	Professional	26	$22.05	$29.19	$197.46
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $10.77 / $34.02 / $214.27	Professional	TC	$10.77	$34.02	$214.27
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $111.93 / $111.93 / $111.93	Professional		$111.93	$111.93	$111.93
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $59.57 / $59.57 / $59.57	Professional	26	$59.57	$59.57	$59.57
United Facility/Professional Professional Modifier Low / Median / High Price $31.84 / $59.20 / $93.49	Professional		$31.84	$59.20	$93.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.04 / $28.06 / $54.62	Professional	26	$22.04	$28.06	$54.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.31 / $31.83 / $47.83	Professional	TC	$10.31	$31.83	$47.83