Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.73 / $106.38 / $175.04	Facility	26	$81.73	$106.38	$175.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.68 / $300.82 / $1,227.67	Professional		$234.68	$300.82	$1,227.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.95 / $87.85 / $281.05	Professional	26	$65.95	$87.85	$281.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $153.04 / $215.94 / $786.52	Professional	TC	$153.04	$215.94	$786.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $160.63 / $167.20 / $167.20	Professional		$160.63	$167.20	$167.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.50 / $79.42 / $113.77	Professional	26	$56.50	$79.42	$113.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $222.45 / $308.20 / $705.62	Professional		$222.45	$308.20	$705.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.95 / $93.70 / $149.94	Professional	26	$79.95	$93.70	$149.94
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $142.49 / $218.28 / $572.16	Professional	TC	$142.49	$218.28	$572.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.25 / $87.25 / $87.25	Facility	26	$87.25	$87.25	$87.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.38 / $350.46 / $634.72	Professional		$192.38	$350.46	$634.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.17 / $100.76 / $171.68	Professional	26	$63.17	$100.76	$171.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $129.88 / $247.93 / $496.81	Professional	TC	$129.88	$247.93	$496.81
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $553.91 / $714.16 / $714.16	Facility	26	$553.91	$714.16	$714.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $248.66 / $391.38 / $2,036.01	Professional		$248.66	$391.38	$2,036.01
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $73.68 / $107.62 / $484.69	Professional	26	$73.68	$107.62	$484.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $165.29 / $303.61 / $2,005.00	Professional	TC	$165.29	$303.61	$2,005.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $138.69 / $138.69 / $138.69	Professional	26	$138.69	$138.69	$138.69
United Facility/Professional Professional Modifier Low / Median / High Price $241.12 / $355.75 / $563.29	Professional		$241.12	$355.75	$563.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.34 / $97.18 / $192.13	Professional	26	$73.34	$97.18	$192.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $160.66 / $235.68 / $394.31	Professional	TC	$160.66	$235.68	$394.31