Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.78 / $30.76 / $44.35	Facility	26	$28.78	$30.76	$44.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.62 / $53.49 / $255.00	Professional		$44.62	$53.49	$255.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $29.57 / $75.25	Professional	26	$26.30	$29.57	$75.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.87 / $23.92 / $132.00	Professional	TC	$21.87	$23.92	$132.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.22 / $35.38 / $38.21	Professional		$33.22	$35.38	$38.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.72 / $29.73 / $41.24	Professional	26	$21.72	$29.73	$41.24
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.06 / $13.06 / $13.06	Professional	TC	$13.06	$13.06	$13.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $57.56 / $92.15	Professional		$51.31	$57.56	$92.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.42 / $31.94 / $52.18	Professional	26	$29.42	$31.94	$52.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.77 / $25.10 / $39.04	Professional	TC	$21.77	$25.10	$39.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.28 / $39.28 / $43.49	Professional		$39.28	$39.28	$43.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.29 / $25.29 / $25.72	Professional	26	$25.29	$25.29	$25.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.99 / $13.99 / $17.76	Professional	TC	$13.99	$13.99	$17.76
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $53.88 / $141.63 / $141.63	Facility	26	$53.88	$141.63	$141.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.56 / $70.63 / $334.42	Professional		$54.56	$70.63	$334.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.33 / $39.28 / $182.49	Professional	26	$30.33	$39.28	$182.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.23 / $31.28 / $151.88	Professional	TC	$24.23	$31.28	$151.88
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $73.66 / $73.66 / $73.66	Professional		$73.66	$73.66	$73.66
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $47.43 / $47.43 / $47.43	Professional	26	$47.43	$47.43	$47.43
United Facility/Professional Professional Modifier Low / Median / High Price $53.14 / $65.47 / $106.29	Professional		$53.14	$65.47	$106.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.06 / $35.77 / $58.54	Professional	26	$30.06	$35.77	$58.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $28.01 / $47.34	Professional	TC	$23.17	$28.01	$47.34