Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.34 / $83.50 / $137.38	Facility	26	$69.34	$83.50	$137.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.40 / $236.40 / $1,087.48	Professional		$195.40	$236.40	$1,087.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.11 / $69.34 / $283.35	Professional	26	$60.11	$69.34	$283.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $130.88 / $158.00 / $786.52	Professional	TC	$130.88	$158.00	$786.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.88 / $44.38 / $69.34	Professional	26	$43.88	$44.38	$69.34
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $106.22 / $106.22 / $106.22	Professional	TC	$106.22	$106.22	$106.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $185.17 / $249.52 / $719.10	Professional		$185.17	$249.52	$719.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.89 / $80.93 / $147.00	Professional	26	$62.89	$80.93	$147.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $122.28 / $170.01 / $588.26	Professional	TC	$122.28	$170.01	$588.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $68.70	Facility	26	$68.70	$68.70	$68.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.24 / $308.81 / $624.38	Professional		$160.24	$308.81	$624.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.84 / $87.12 / $157.58	Professional	26	$52.84	$87.12	$157.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $111.31 / $227.76 / $510.77	Professional	TC	$111.31	$227.76	$510.77
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $434.48 / $561.91 / $561.91	Facility	26	$434.48	$561.91	$561.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $206.79 / $383.60 / $2,075.08	Professional		$206.79	$383.60	$2,075.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $64.68 / $87.88 / $460.66	Professional	26	$64.68	$87.88	$460.66
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $141.41 / $283.29 / $1,685.33	Professional	TC	$141.41	$283.29	$1,685.33
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $108.63 / $108.63 / $108.63	Professional	26	$108.63	$108.63	$108.63
United Facility/Professional Professional Modifier Low / Median / High Price $201.65 / $304.81 / $484.37	Professional		$201.65	$304.81	$484.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.97 / $78.81 / $130.31	Professional	26	$63.97	$78.81	$130.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $137.38 / $210.33 / $378.17	Professional	TC	$137.38	$210.33	$378.17