Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.38 / $145.52 / $1,117.67	Facility		$37.38	$145.52	$1,117.67
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.59 / $17.67 / $29.05	Facility	26	$13.59	$17.67	$29.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.91 / $37.38 / $98.42	Professional		$30.91	$37.38	$98.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.37 / $18.13 / $63.84	Professional	26	$12.37	$18.13	$63.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.13 / $23.78 / $49.07	Professional	TC	$18.13	$23.78	$49.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.29 / $30.08 / $31.66	Professional		$27.29	$30.08	$31.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.92 / $14.98 / $23.09	Professional	26	$9.92	$14.98	$23.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.43 / $38.67 / $68.66	Professional		$31.43	$38.67	$68.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.33 / $17.69 / $28.89	Professional	26	$14.33	$17.69	$28.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.11 / $21.41 / $41.39	Professional	TC	$17.11	$21.41	$41.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.87 / $42.87 / $42.87	Facility		$42.87	$42.87	$42.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.88 / $15.88 / $15.88	Facility	26	$15.88	$15.88	$15.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.73 / $43.70 / $85.37	Professional		$28.73	$43.70	$85.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.62 / $18.53 / $33.38	Professional	26	$11.62	$18.53	$33.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.41 / $25.38 / $55.92	Professional	TC	$17.41	$25.38	$55.92
Medica Facility/Professional Facility Modifier Low / Median / High Price $34.36 / $50.71 / $87.45	Facility		$34.36	$50.71	$87.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $31.93 / $100.00 / $100.00	Facility	26	$31.93	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.63 / $44.72 / $287.00	Professional		$32.63	$44.72	$287.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.33 / $18.11 / $204.67	Professional	26	$14.33	$18.11	$204.67
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $26.42 / $230.00	Professional	TC	$18.48	$26.42	$230.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $24.40 / $24.40 / $26.55	Professional	26	$24.40	$24.40	$26.55
United Facility/Professional Professional Modifier Low / Median / High Price $32.21 / $40.63 / $70.56	Professional		$32.21	$40.63	$70.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.87 / $16.38 / $27.10	Professional	26	$13.87	$16.38	$27.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $23.29 / $38.67	Professional	TC	$17.57	$23.29	$38.67