Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.11 / $75.34 / $128.88	Facility	26	$70.11	$75.34	$128.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.49 / $259.57 / $924.61	Professional		$164.49	$259.57	$924.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.53 / $75.36 / $254.87	Professional	26	$58.53	$75.36	$254.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.15 / $159.63 / $525.37	Professional	TC	$98.15	$159.63	$525.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.87 / $79.87 / $79.87	Professional		$79.87	$79.87	$79.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.98 / $56.35 / $90.70	Professional	26	$44.98	$56.35	$90.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.69 / $207.12 / $454.77	Professional		$150.69	$207.12	$454.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.25 / $81.02 / $133.76	Professional	26	$63.25	$81.02	$133.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.44 / $124.49 / $335.70	Professional	TC	$87.44	$124.49	$335.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.44 / $69.44 / $69.44	Facility	26	$69.44	$69.44	$69.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.82 / $241.23 / $450.00	Professional		$130.82	$241.23	$450.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.04 / $86.61 / $151.36	Professional	26	$53.04	$86.61	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.39 / $157.50 / $318.52	Professional	TC	$80.39	$157.50	$318.52
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $441.84 / $568.24 / $568.24	Facility	26	$441.84	$568.24	$568.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $167.09 / $275.14 / $1,403.43	Professional		$167.09	$275.14	$1,403.43
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $64.19 / $87.24 / $384.88	Professional	26	$64.19	$87.24	$384.88
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $101.41 / $192.68 / $1,332.00	Professional	TC	$101.41	$192.68	$1,332.00
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 $162.18 / $210.41 / $379.83	Professional		$162.18	$210.41	$379.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.40 / $79.67 / $152.52	Professional	26	$62.40	$79.67	$152.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.57 / $141.97 / $260.08	Professional	TC	$97.57	$141.97	$260.08