Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.11 / $77.03 / $128.26	Facility	26	$70.11	$77.03	$128.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.58 / $259.57 / $983.61	Professional		$173.58	$259.57	$983.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.53 / $81.90 / $286.16	Professional	26	$58.53	$81.90	$286.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $103.68 / $177.61 / $558.89	Professional	TC	$103.68	$177.61	$558.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.55 / $120.55 / $267.86	Professional		$91.55	$120.55	$267.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.08 / $67.62 / $95.99	Professional	26	$45.08	$67.62	$95.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.65 / $208.63 / $464.86	Professional		$160.65	$208.63	$464.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.25 / $81.02 / $133.06	Professional	26	$63.25	$81.02	$133.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.40 / $128.38 / $335.21	Professional	TC	$97.40	$128.38	$335.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.79 / $69.79 / $69.79	Facility	26	$69.79	$69.79	$69.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.60 / $272.73 / $512.89	Professional		$138.60	$272.73	$512.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.06 / $86.90 / $151.36	Professional	26	$53.06	$86.90	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.15 / $196.87 / $398.57	Professional	TC	$88.15	$196.87	$398.57
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $441.84 / $571.36 / $571.36	Facility	26	$441.84	$571.36	$571.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $199.45 / $314.44 / $1,670.68	Professional		$199.45	$314.44	$1,670.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $63.81 / $87.97 / $520.49	Professional	26	$63.81	$87.97	$520.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $134.94 / $244.65 / $1,318.41	Professional	TC	$134.94	$244.65	$1,318.41
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $110.39 / $110.39 / $110.39	Professional	26	$110.39	$110.39	$110.39
United Facility/Professional Professional Modifier Low / Median / High Price $195.34 / $261.64 / $523.77	Professional		$195.34	$261.64	$523.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.07 / $76.18 / $142.00	Professional	26	$61.07	$76.18	$142.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.04 / $186.61 / $296.79	Professional	TC	$123.04	$186.61	$296.79