Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $25.12 / $28.84	Professional	26	$19.05	$25.12	$28.84
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $104.71 / $104.71	Facility	26	$38.90	$104.71	$104.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $87.10 / $245.47	Professional		$61.66	$87.10	$245.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $21.88 / $125.89	Professional	26	$16.98	$21.88	$125.89
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $63.10 / $338.84	Professional	TC	$44.67	$63.10	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $85.11 / $162.18	Professional		$61.66	$85.11	$162.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $20.89 / $27.54	Professional	26	$16.60	$20.89	$27.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $61.66 / $138.04	Professional	TC	$44.67	$61.66	$138.04