Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.02 / $12.36 / $16.23	Facility	26	$10.02	$12.36	$16.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.45 / $62.60 / $176.58	Professional		$37.45	$62.60	$176.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.78 / $13.71 / $45.57	Professional	26	$9.78	$13.71	$45.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.26 / $45.65 / $110.48	Professional	TC	$27.26	$45.65	$110.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.56 / $40.31 / $59.86	Professional		$30.56	$40.31	$59.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.84 / $12.43 / $20.35	Professional	26	$8.84	$12.43	$20.35
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.23 / $24.23 / $24.23	Professional	TC	$24.23	$24.23	$24.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.91 / $64.04 / $99.02	Professional		$50.91	$64.04	$99.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.03 / $16.53 / $27.62	Professional	26	$12.03	$16.53	$27.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.04 / $48.04 / $72.05	Professional	TC	$36.04	$48.04	$72.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.75 / $67.88 / $118.27	Professional		$39.75	$67.88	$118.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.44 / $16.39 / $28.45	Professional	26	$10.44	$16.39	$28.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.96 / $50.95 / $91.92	Professional	TC	$28.96	$50.95	$91.92
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $23.82 / $100.00 / $100.00	Facility	26	$23.82	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.17 / $76.84 / $632.00	Professional		$49.17	$76.84	$632.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.88 / $17.32 / $223.21	Professional	26	$11.88	$17.32	$223.21
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $36.93 / $58.23 / $259.02	Professional	TC	$36.93	$58.23	$259.02
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $108.76 / $108.76 / $108.76	Professional		$108.76	$108.76	$108.76
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $9.81 / $14.33 / $23.40	Professional	26	$9.81	$14.33	$23.40
United Facility/Professional Professional Modifier Low / Median / High Price $45.20 / $65.83 / $108.67	Professional		$45.20	$65.83	$108.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $16.11 / $26.05	Professional	26	$11.32	$16.11	$26.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.18 / $52.19 / $84.28	Professional	TC	$35.18	$52.19	$84.28