Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Facility		$213.80	$213.80	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $38.90 / $151.36	Professional		$20.89	$38.90	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $14.45 / $41.69	Professional	26	$5.01	$14.45	$41.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $23.99 / $125.89	Professional	TC	$15.85	$23.99	$125.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $28.18 / $31.62	Professional		$13.80	$28.18	$31.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.16 / $6.76 / $9.77	Professional	26	$3.16	$6.76	$9.77
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $22.91 / $25.12	Professional	TC	$22.91	$22.91	$25.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $38.02 / $89.13	Professional		$24.55	$38.02	$89.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $11.22 / $34.67	Professional	26	$6.03	$11.22	$34.67
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $26.92 / $51.29	Professional	TC	$18.20	$26.92	$51.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $33.88 / $74.13	Professional		$29.51	$33.88	$74.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $8.32 / $12.88	Professional	26	$6.31	$8.32	$12.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $26.30 / $61.66	Professional	TC	$22.91	$26.30	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $23.99 / $114.82	Professional		$14.79	$23.99	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.24 / $5.62 / $102.33	Professional	26	$3.24	$5.62	$102.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $20.89 / $95.50	Professional	TC	$11.48	$20.89	$95.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $41.69 / $104.71	Facility		$27.54	$41.69	$104.71
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 $19.05 / $52.48 / $263.03	Professional		$19.05	$52.48	$263.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $4.37 / $9.33 / $144.54	Professional	26	$4.37	$9.33	$144.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $40.74 / $223.87	Professional	TC	$14.45	$40.74	$223.87
United Facility/Professional Facility Modifier Low / Median / High Price $3.24 / $12.88 / $16.22	Facility		$3.24	$12.88	$16.22
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $30.90 / $70.79	Professional		$19.05	$30.90	$70.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.98 / $7.08 / $13.80	Professional	26	$3.98	$7.08	$13.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $23.44 / $56.23	Professional	TC	$14.45	$23.44	$56.23