Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $158.49 / $363.08	Facility	26	$87.10	$158.49	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $288.40 / $1,318.26	Professional		$213.80	$288.40	$1,318.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $95.50 / $229.09	Professional	26	$64.57	$95.50	$229.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $199.53 / $489.78	Professional	TC	$141.25	$199.53	$489.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $70.79 / $125.89	Professional	26	$56.23	$70.79	$125.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $309.03 / $645.65	Professional		$223.87	$309.03	$645.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $93.33 / $151.36	Professional	26	$79.43	$93.33	$151.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $218.78 / $457.09	Professional	TC	$141.25	$218.78	$457.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $239.88 / $380.19	Professional		$234.42	$239.88	$380.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $83.18 / $125.89	Professional	26	$81.28	$83.18	$125.89
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $169.82 / $269.15	Professional	TC	$151.36	$169.82	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $346.74 / $645.65	Professional		$204.17	$346.74	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $100.00 / $190.55	Professional	26	$61.66	$100.00	$190.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $245.47 / $501.19	Professional	TC	$134.90	$245.47	$501.19
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $549.54 / $707.95 / $707.95	Facility	26	$549.54	$707.95	$707.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $389.05 / $2,041.74	Professional		$239.88	$389.05	$2,041.74
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $107.15 / $489.78	Professional	26	$70.79	$107.15	$489.78
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $295.12 / $1,995.26	Professional	TC	$158.49	$295.12	$1,995.26
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $138.04 / $138.04	Professional	26	$138.04	$138.04	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $316.23 / $512.86	Professional		$223.87	$316.23	$512.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $89.13 / $154.88	Professional	26	$69.18	$89.13	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $213.80 / $371.54	Professional	TC	$147.91	$213.80	$371.54