Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.69 / $10.56 / $13.03	Facility	26	$8.69	$10.56	$13.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.75 / $64.72 / $146.63	Professional		$52.75	$64.72	$146.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $9.60 / $22.44	Professional	26	$8.13	$9.60	$22.44
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $26.26 / $29.10 / $41.38	Professional	52	$26.26	$29.10	$41.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.70 / $50.39 / $112.15	Professional	TC	$44.70	$50.39	$112.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.11 / $63.95 / $85.57	Professional		$45.11	$63.95	$85.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $10.50 / $13.71	Professional	26	$7.56	$10.50	$13.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $39.45 / $39.45 / $39.45	Professional	TC	$39.45	$39.45	$39.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.81 / $55.13 / $90.99	Professional		$43.81	$55.13	$90.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.22 / $9.58 / $14.97	Professional	26	$7.22	$9.58	$14.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.58 / $45.78 / $76.76	Professional	TC	$36.58	$45.78	$76.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.92 / $72.43 / $118.46	Professional		$52.92	$72.43	$118.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $11.85 / $19.16	Professional	26	$8.56	$11.85	$19.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.43 / $60.81 / $98.16	Professional	TC	$44.43	$60.81	$98.16
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $20.60 / $20.60 / $80.00	Facility	26	$20.60	$20.60	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.72 / $69.81 / $373.69	Professional		$49.72	$69.81	$373.69
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.97 / $11.63 / $55.28	Professional	26	$7.97	$11.63	$55.28
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $41.92 / $58.86 / $318.41	Professional	TC	$41.92	$58.86	$318.41
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $97.37 / $97.37 / $97.37	Professional		$97.37	$97.37	$97.37
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $12.40 / $16.43	Professional	26	$8.51	$12.40	$16.43
United Facility/Professional Professional Modifier Low / Median / High Price $47.05 / $66.79 / $112.10	Professional		$47.05	$66.79	$112.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $11.23 / $18.91	Professional	26	$7.50	$11.23	$18.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.89 / $56.04 / $93.89	Professional	TC	$38.89	$56.04	$93.89