Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $16.85 / $29.72	Facility	26	$11.48	$16.85	$29.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.15 / $43.96 / $184.83	Professional		$38.15	$43.96	$184.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $14.79 / $51.84	Professional	26	$11.48	$14.79	$51.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $18.12 / $21.32 / $24.72	Professional	52	$18.12	$21.32	$24.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.67 / $30.04 / $70.11	Professional	TC	$24.67	$30.04	$70.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.75 / $38.81 / $38.81	Professional		$33.75	$38.81	$38.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.62 / $16.79 / $19.52	Professional	26	$12.62	$16.79	$19.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.44 / $44.40 / $74.33	Professional		$34.44	$44.40	$74.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.18 / $17.80 / $27.93	Professional	26	$14.18	$17.80	$27.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.26 / $27.63 / $51.47	Professional	TC	$20.26	$27.63	$51.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.96 / $14.96 / $14.96	Facility	26	$14.96	$14.96	$14.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.86 / $53.11 / $87.81	Professional		$32.86	$53.11	$87.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.46 / $18.71 / $28.66	Professional	26	$11.46	$18.71	$28.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.75 / $34.40 / $63.16	Professional	TC	$21.75	$34.40	$63.16
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $30.31 / $80.00 / $80.00	Facility	26	$30.31	$80.00	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.06 / $54.32 / $290.45	Professional		$39.06	$54.32	$290.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.37 / $18.48 / $82.68	Professional	26	$13.37	$18.48	$82.68
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.83 / $36.82 / $207.72	Professional	TC	$24.83	$36.82	$207.72
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $23.48 / $23.48 / $23.48	Professional	26	$23.48	$23.48	$23.48
United Facility/Professional Professional Modifier Low / Median / High Price $38.92 / $49.25 / $77.31	Professional		$38.92	$49.25	$77.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.09 / $16.32 / $30.95	Professional	26	$13.09	$16.32	$30.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.41 / $35.32 / $58.73	Professional	TC	$24.41	$35.32	$58.73