Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.73 / $24.38 / $32.60	Facility	26	$21.73	$24.38	$32.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.40 / $37.10 / $92.65	Professional		$32.40	$37.10	$92.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.33 / $23.85 / $50.06	Professional	26	$21.33	$23.85	$50.06
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.78 / $17.45 / $21.97	Professional	52	$15.78	$17.45	$21.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.56 / $12.19 / $23.82	Professional	TC	$10.56	$12.19	$23.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.50 / $37.10 / $53.34	Professional		$28.50	$37.10	$53.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.32 / $28.07 / $31.08	Professional	26	$20.32	$28.07	$31.08
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $8.19 / $8.19 / $8.19	Professional	52	$8.19	$8.19	$8.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $58.28 / $130.28	Professional		$32.36	$58.28	$130.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.05 / $33.82 / $56.00	Professional	26	$23.05	$33.82	$56.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $25.63 / $71.92	Professional	TC	$10.72	$25.63	$71.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.13 / $44.15 / $72.13	Professional		$33.13	$44.15	$72.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.91 / $29.92 / $49.32	Professional	26	$21.91	$29.92	$49.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.93 / $14.87 / $23.90	Professional	TC	$10.93	$14.87	$23.90
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $51.77 / $51.77 / $98.42	Facility	26	$51.77	$51.77	$98.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.86 / $43.20 / $209.51	Professional		$30.86	$43.20	$209.51
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $20.56 / $29.33 / $138.46	Professional	26	$20.56	$29.33	$138.46
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $9.49 / $13.74 / $71.05	Professional	TC	$9.49	$13.74	$71.05
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $61.34 / $61.34 / $61.34	Professional		$61.34	$61.34	$61.34
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $31.11 / $31.11 / $31.11	Professional	26	$31.11	$31.11	$31.11
United Facility/Professional Professional Modifier Low / Median / High Price $29.15 / $41.91 / $72.92	Professional		$29.15	$41.91	$72.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.66 / $28.15 / $48.01	Professional	26	$19.66	$28.15	$48.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.27 / $13.11 / $22.56	Professional	TC	$9.27	$13.11	$22.56