Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $87.10 / $87.10	Facility		$63.10	$87.10	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $15.85 / $75.86	Professional		$9.12	$15.85	$75.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.02 / $6.61 / $14.13	Professional	26	$3.02	$6.61	$14.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $7.08 / $10.00 / $70.79	Professional	TC	$7.08	$10.00	$70.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $7.41 / $16.22 / $16.22	Professional		$7.41	$16.22	$16.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $2.00 / $4.17 / $7.08	Professional	26	$2.00	$4.17	$7.08
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $10.72 / $11.48	Professional	TC	$10.72	$10.72	$11.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $19.05 / $42.66	Professional		$12.88	$19.05	$42.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $3.98 / $7.24 / $20.89	Professional	26	$3.98	$7.24	$20.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $8.71 / $12.30 / $30.20	Professional	TC	$8.71	$12.30	$30.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $16.98 / $34.67	Professional		$14.79	$16.98	$34.67
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.07 / $5.37 / $7.59	Professional	26	$4.07	$5.37	$7.59
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $12.30 / $26.92	Professional	TC	$10.72	$12.30	$26.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $12.30 / $51.29	Professional		$7.24	$12.30	$51.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.09 / $3.63 / $25.70	Professional	26	$2.09	$3.63	$25.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $5.13 / $9.55 / $40.74	Professional	TC	$5.13	$9.55	$40.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $20.42 / $50.12	Facility		$13.49	$20.42	$50.12
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $25.12 / $123.03	Professional		$9.55	$25.12	$123.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $2.82 / $6.17 / $87.10	Professional	26	$2.82	$6.17	$87.10
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $6.76 / $17.78 / $97.72	Professional	TC	$6.76	$17.78	$97.72
United Facility/Professional Facility Modifier Low / Median / High Price $2.09 / $6.03 / $8.13	Facility		$2.09	$6.03	$8.13
United Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $15.85 / $35.48	Professional		$9.55	$15.85	$35.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.63 / $4.68 / $8.71	Professional	26	$2.63	$4.68	$8.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $6.76 / $10.96 / $25.12	Professional	TC	$6.76	$10.96	$25.12