Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $100.00 / $251.19	Facility	26	$57.54	$100.00	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $269.15 / $724.44	Professional		$173.78	$269.15	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $83.18 / $239.88	Professional	26	$52.48	$83.18	$239.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $177.83 / $416.87	Professional	TC	$123.03	$177.83	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $131.83 / $138.04	Professional		$128.82	$131.83	$138.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $56.23 / $93.33	Professional	26	$39.81	$56.23	$93.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $309.03 / $524.81	Professional		$245.47	$309.03	$524.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $81.28 / $134.90	Professional	26	$69.18	$81.28	$134.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $223.87 / $371.54	Professional	TC	$173.78	$223.87	$371.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $213.80 / $363.08	Professional		$190.55	$213.80	$363.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $63.10 / $91.20	Professional	26	$56.23	$63.10	$91.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $147.91 / $275.42	Professional	TC	$131.83	$147.91	$275.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $302.00 / $588.84	Professional		$165.96	$302.00	$588.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $79.43 / $154.88	Professional	26	$47.86	$79.43	$154.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $229.09 / $467.74	Professional	TC	$117.49	$229.09	$467.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $389.05 / $501.19 / $501.19	Facility	26	$389.05	$501.19	$501.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $363.08 / $1,949.84	Professional		$213.80	$363.08	$1,949.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $87.10 / $562.34	Professional	26	$56.23	$87.10	$562.34
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $288.40 / $1,548.82	Professional	TC	$151.36	$288.40	$1,548.82
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $97.72 / $97.72	Professional	26	$97.72	$97.72	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $295.12 / $467.74	Professional		$199.53	$295.12	$467.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $70.79 / $114.82	Professional	26	$53.70	$70.79	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $213.80 / $354.81	Professional	TC	$144.54	$213.80	$354.81