Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.07 / $11.34 / $19.57	Facility	26	$9.07	$11.34	$19.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.97 / $52.41 / $254.00	Professional		$32.97	$52.41	$254.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $10.39 / $36.45	Professional	26	$8.34	$10.39	$36.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.71 / $36.60 / $150.52	Professional	TC	$24.71	$36.60	$150.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $31.17 / $57.97	Professional		$22.39	$31.17	$57.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.96 / $9.80 / $13.38	Professional	26	$6.96	$9.80	$13.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.04 / $43.51 / $43.51	Professional	TC	$25.04	$43.51	$43.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.22 / $49.51 / $141.30	Professional		$36.22	$49.51	$141.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.74 / $12.96 / $21.06	Professional	26	$9.74	$12.96	$21.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.48 / $36.79 / $120.70	Professional	TC	$26.48	$36.79	$120.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.96 / $62.82 / $151.36	Professional		$32.96	$62.82	$151.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.25 / $13.54 / $20.63	Professional	26	$8.25	$13.54	$20.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.11 / $48.79 / $125.28	Professional	TC	$25.11	$48.79	$125.28
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $39.20 / $80.00 / $80.00	Facility	26	$39.20	$80.00	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.09 / $75.48 / $539.95	Professional		$39.09	$75.48	$539.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.59 / $14.70 / $97.55	Professional	26	$8.59	$14.70	$97.55
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.06 / $58.95 / $492.53	Professional	TC	$29.06	$58.95	$492.53
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $66.67 / $66.67 / $66.67	Professional		$66.67	$66.67	$66.67
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $17.07 / $17.07	Professional	26	$17.07	$17.07	$17.07
United Facility/Professional Professional Modifier Low / Median / High Price $38.72 / $58.03 / $138.68	Professional		$38.72	$58.03	$138.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.15 / $12.75 / $34.96	Professional	26	$8.15	$12.75	$34.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.73 / $42.72 / $103.72	Professional	TC	$28.73	$42.72	$103.72