Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $167.96 / $167.96 / $1,579.50	Facility		$167.96	$167.96	$1,579.50
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $257.99 / $257.99 / $257.99	Facility	TC	$257.99	$257.99	$257.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.64 / $88.88 / $220.00	Professional		$65.64	$88.88	$220.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.96 / $21.53 / $89.30	Professional	26	$9.96	$21.53	$89.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.56 / $65.40 / $132.57	Professional	TC	$54.56	$65.40	$132.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.59 / $47.59 / $47.59	Professional		$47.59	$47.59	$47.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $13.05 / $19.25	Professional	26	$5.01	$13.05	$19.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.80 / $87.20 / $139.10	Professional		$28.80	$87.20	$139.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.04 / $19.48 / $23.58	Professional	26	$5.04	$19.48	$23.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.76 / $70.20 / $115.49	Professional	TC	$23.76	$70.20	$115.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.92 / $41.61 / $153.00	Professional		$30.92	$41.61	$153.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.74 / $11.49 / $39.83	Professional	26	$5.74	$11.49	$39.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.06 / $35.51 / $107.51	Professional	TC	$23.06	$35.51	$107.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $50.19 / $77.81 / $179.36	Facility		$50.19	$77.81	$179.36
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 $319.41 / $319.41 / $319.41	Facility	TC	$319.41	$319.41	$319.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.34 / $97.27 / $514.55	Professional		$46.34	$97.27	$514.55
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.58 / $16.63 / $87.52	Professional	26	$7.58	$16.63	$87.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $38.76 / $83.02 / $439.92	Professional	TC	$38.76	$83.02	$439.92
United Facility/Professional Professional Modifier Low / Median / High Price $46.34 / $69.47 / $154.46	Professional		$46.34	$69.47	$154.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.25 / $12.47 / $25.28	Professional	26	$7.25	$12.47	$25.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.76 / $61.96 / $120.20	Professional	TC	$38.76	$61.96	$120.20