Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.25 / $81.15 / $121.91	Facility	26	$70.25	$81.15	$121.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.36 / $314.01 / $1,141.50	Professional		$202.36	$314.01	$1,141.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.95 / $99.53 / $307.27	Professional	26	$62.95	$99.53	$307.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.27 / $220.00 / $760.02	Professional	TC	$125.27	$220.00	$760.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.64 / $139.32 / $155.69	Professional		$105.64	$139.32	$155.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.27 / $62.89 / $91.65	Professional	26	$48.27	$62.89	$91.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $85.62 / $85.62 / $101.77	Professional	TC	$85.62	$85.62	$101.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $184.83 / $261.41 / $582.11	Professional		$184.83	$261.41	$582.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.45 / $87.05 / $143.32	Professional	26	$68.45	$87.05	$143.32
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $116.37 / $176.53 / $454.56	Professional	TC	$116.37	$176.53	$454.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.84 / $74.84 / $74.84	Facility	26	$74.84	$74.84	$74.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.47 / $289.49 / $523.49	Professional		$160.47	$289.49	$523.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.98 / $93.49 / $163.75	Professional	26	$56.98	$93.49	$163.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $106.73 / $202.48 / $402.42	Professional	TC	$106.73	$202.48	$402.42
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $473.36 / $612.88 / $612.88	Facility	26	$473.36	$612.88	$612.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $205.71 / $322.33 / $1,680.90	Professional		$205.71	$322.33	$1,680.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $68.92 / $95.21 / $414.94	Professional	26	$68.92	$95.21	$414.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $134.97 / $240.24 / $1,425.00	Professional	TC	$134.97	$240.24	$1,425.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $118.48 / $118.48 / $118.48	Professional	26	$118.48	$118.48	$118.48
United Facility/Professional Professional Modifier Low / Median / High Price $200.85 / $291.51 / $441.30	Professional		$200.85	$291.51	$441.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.03 / $82.45 / $152.66	Professional	26	$65.03	$82.45	$152.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $129.29 / $188.95 / $331.33	Professional	TC	$129.29	$188.95	$331.33