Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.01 / $9.64 / $12.02	Facility	26	$8.01	$9.64	$12.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.07 / $38.47 / $101.76	Professional		$26.07	$38.47	$101.76
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $37.15 / $47.07 / $47.07	Professional	25	$37.15	$47.07	$47.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.80 / $9.89 / $24.95	Professional	26	$7.80	$9.89	$24.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.63 / $26.90 / $65.51	Professional	TC	$17.63	$26.90	$65.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.17 / $28.48 / $42.01	Professional		$23.17	$28.48	$42.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.48 / $10.35 / $12.64	Professional	26	$7.48	$10.35	$12.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.11 / $38.02 / $54.90	Professional		$31.11	$38.02	$54.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.16 / $10.78 / $17.30	Professional	26	$8.16	$10.78	$17.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.19 / $27.77 / $41.46	Professional	TC	$21.19	$27.77	$41.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.72 / $41.72 / $70.72	Professional		$27.72	$41.72	$70.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.89 / $11.02 / $18.21	Professional	26	$7.89	$11.02	$18.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.16 / $30.50 / $53.49	Professional	TC	$19.16	$30.50	$53.49
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $18.87 / $100.00 / $100.00	Facility	26	$18.87	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.01 / $45.26 / $400.00	Professional		$30.01	$45.26	$400.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.60 / $11.31 / $132.09	Professional	26	$7.60	$11.31	$132.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.02 / $34.03 / $135.32	Professional	TC	$22.02	$34.03	$135.32
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $41.10 / $64.48 / $64.48	Professional		$41.10	$64.48	$64.48
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $11.39 / $12.91 / $15.17	Professional	26	$11.39	$12.91	$15.17
United Facility/Professional Professional Modifier Low / Median / High Price $28.61 / $40.28 / $68.81	Professional		$28.61	$40.28	$68.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.89 / $10.39 / $18.37	Professional	26	$6.89	$10.39	$18.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.57 / $30.75 / $52.54	Professional	TC	$20.57	$30.75	$52.54