Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.98 / $64.98 / $92.04	Facility		$64.98	$64.98	$92.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $93.64 / $93.64 / $93.64	Facility	TC	$93.64	$93.64	$93.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.41 / $18.35 / $48.45	Professional		$15.41	$18.35	$48.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.24 / $13.07 / $39.29	Professional	26	$10.24	$13.07	$39.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $6.42 / $7.01 / $15.33	Professional	TC	$6.42	$7.01	$15.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $9.06 / $9.06 / $9.06	Professional		$9.06	$9.06	$9.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.16 / $7.85 / $18.91	Professional	26	$5.16	$7.85	$18.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.07 / $25.18 / $36.21	Professional		$9.07	$25.18	$36.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.33 / $19.55 / $24.29	Professional	26	$5.33	$19.55	$24.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.32 / $5.84 / $12.89	Professional	TC	$3.32	$5.84	$12.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.32 / $13.11 / $45.05	Professional		$9.32	$13.11	$45.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.74 / $11.49 / $32.27	Professional	26	$5.74	$11.49	$32.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2.94 / $4.30 / $13.51	Professional	TC	$2.94	$4.30	$13.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $16.44 / $22.32 / $45.30	Facility		$16.44	$22.32	$45.30
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 Facility Modifier TC Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	TC	$100.00	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $13.21 / $28.07 / $130.47	Professional		$13.21	$28.07	$130.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.80 / $16.94 / $95.76	Professional	26	$7.80	$16.94	$95.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $5.41 / $9.91 / $95.76	Professional	TC	$5.41	$9.91	$95.76
United Facility/Professional Professional Modifier Low / Median / High Price $12.19 / $21.59 / $42.63	Professional		$12.19	$21.59	$42.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.23 / $12.85 / $25.28	Professional	26	$7.23	$12.85	$25.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $4.88 / $8.74 / $18.04	Professional	TC	$4.88	$8.74	$18.04