Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.18 / $14.43 / $17.87	Facility	26	$12.18	$14.43	$17.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.24 / $64.88 / $146.31	Professional		$52.24	$64.88	$146.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.24 / $15.21 / $40.93	Professional	26	$11.24	$15.21	$40.93
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $25.26 / $27.94 / $37.65	Professional	52	$25.26	$27.94	$37.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.11 / $45.52 / $102.98	Professional	TC	$39.11	$45.52	$102.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.04 / $65.34 / $86.81	Professional		$48.04	$65.34	$86.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.18 / $14.24 / $18.45	Professional	26	$10.18	$14.24	$18.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.65 / $37.65 / $37.65	Professional	TC	$37.65	$37.65	$37.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.45 / $54.67 / $89.19	Professional		$44.45	$54.67	$89.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $12.91 / $20.71	Professional	26	$10.83	$12.91	$20.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.61 / $41.93 / $69.48	Professional	TC	$33.61	$41.93	$69.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.47 / $70.48 / $115.67	Professional		$52.47	$70.48	$115.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.80 / $16.45 / $26.56	Professional	26	$11.80	$16.45	$26.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.65 / $55.09 / $89.14	Professional	TC	$40.65	$55.09	$89.14
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $27.92 / $27.92 / $80.00	Facility	26	$27.92	$27.92	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.05 / $68.27 / $346.85	Professional		$49.05	$68.27	$346.85
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.37 / $16.10 / $74.58	Professional	26	$11.37	$16.10	$74.58
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $36.94 / $52.34 / $272.27	Professional	TC	$36.94	$52.34	$272.27
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $11.45 / $16.77 / $22.14	Professional	26	$11.45	$16.77	$22.14
United Facility/Professional Professional Modifier Low / Median / High Price $46.33 / $65.83 / $116.28	Professional		$46.33	$65.83	$116.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.74 / $15.16 / $25.85	Professional	26	$10.74	$15.16	$25.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.59 / $50.19 / $90.43	Professional	TC	$35.59	$50.19	$90.43