Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $23.44 / $41.69	Facility	26	$16.98	$23.44	$41.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $104.71 / $245.47	Professional		$69.18	$104.71	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $26.30 / $83.18	Professional	26	$15.14	$26.30	$83.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $83.18 / $173.78	Professional	TC	$56.23	$83.18	$173.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $75.86 / $165.96	Professional		$72.44	$75.86	$165.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $19.50 / $28.18	Professional	26	$13.18	$19.50	$28.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $100.00 / $177.83	Professional		$81.28	$100.00	$177.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $23.44 / $36.31	Professional	26	$18.62	$23.44	$36.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $75.86 / $147.91	Professional	TC	$61.66	$75.86	$147.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $107.15 / $141.25	Professional		$100.00	$107.15	$141.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $21.38 / $28.84	Professional	26	$19.05	$21.38	$28.84
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $87.10 / $114.82	Professional	TC	$74.13	$87.10	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $114.82 / $213.80	Professional		$75.86	$114.82	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $24.55 / $44.67	Professional	26	$15.85	$24.55	$44.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $95.50 / $181.97	Professional	TC	$60.26	$95.50	$181.97
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $81.28 / $81.28	Facility	26	$41.69	$81.28	$81.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $120.23 / $660.69	Professional		$81.28	$120.23	$660.69
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $23.99 / $114.82	Professional	26	$17.38	$23.99	$114.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $97.72 / $549.54	Professional	TC	$66.07	$97.72	$549.54
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $32.36 / $32.36	Professional	26	$32.36	$32.36	$32.36
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $104.71 / $165.96	Professional		$81.28	$104.71	$165.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $20.89 / $33.88	Professional	26	$16.98	$20.89	$33.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $85.11 / $138.04	Professional	TC	$66.07	$85.11	$138.04