Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.78 / $18.20 / $42.66	Facility	26	$17.78	$18.20	$42.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $75.86 / $407.38	Professional		$53.70	$75.86	$407.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $28.18 / $107.15	Professional	26	$16.60	$28.18	$107.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $28.84 / $177.83 / $177.83	Professional	50	$28.84	$177.83	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $44.67 / $83.18	Professional	TC	$36.31	$44.67	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $69.18 / $91.20	Professional		$52.48	$69.18	$91.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $23.44 / $24.55	Professional	26	$16.98	$23.44	$24.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $58.88 / $100.00	Professional		$43.65	$58.88	$100.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $19.05 / $29.51	Professional	26	$14.79	$19.05	$29.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $39.81 / $70.79	Professional	TC	$29.51	$39.81	$70.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $74.13 / $104.71	Professional		$63.10	$74.13	$104.71
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $22.39 / $30.20	Professional	26	$19.05	$22.39	$30.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $52.48 / $74.13	Professional	TC	$43.65	$52.48	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $79.43 / $120.23	Professional		$57.54	$79.43	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $25.70 / $39.81	Professional	26	$18.20	$25.70	$39.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $54.95 / $85.11	Professional	TC	$38.90	$54.95	$85.11
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $81.28 / $81.28	Facility	26	$41.69	$81.28	$81.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $79.43 / $416.87	Professional		$56.23	$79.43	$416.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $25.12 / $114.82	Professional	26	$17.38	$25.12	$114.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $53.70 / $302.00	Professional	TC	$38.02	$53.70	$302.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $89.13	Professional		$79.43	$79.43	$89.13
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $70.79 / $112.20	Professional		$52.48	$70.79	$112.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $21.38 / $35.48	Professional	26	$16.98	$21.38	$35.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $47.86 / $79.43	Professional	TC	$35.48	$47.86	$79.43