Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.51 / $79.48 / $120.56	Facility	26	$67.51	$79.48	$120.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.20 / $425.00 / $1,332.89	Professional		$263.20	$425.00	$1,332.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.52 / $126.45 / $399.00	Professional	26	$70.52	$126.45	$399.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $201.61 / $299.00 / $931.29	Professional	TC	$201.61	$299.00	$931.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $155.96 / $155.96 / $155.96	Professional		$155.96	$155.96	$155.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.87 / $62.81 / $94.02	Professional	26	$41.87	$62.81	$94.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $250.18 / $362.73 / $799.13	Professional		$250.18	$362.73	$799.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.44 / $75.87 / $124.22	Professional	26	$59.44	$75.87	$124.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.75 / $282.76 / $674.93	Professional	TC	$190.75	$282.76	$674.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $64.84	Facility	26	$64.84	$64.84	$64.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $187.30 / $405.72 / $896.02	Professional		$187.30	$405.72	$896.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.52 / $82.07 / $142.27	Professional	26	$49.52	$82.07	$142.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $142.22 / $331.55 / $800.03	Professional	TC	$142.22	$331.55	$800.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $409.92 / $530.79 / $530.79	Facility	26	$409.92	$530.79	$530.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $246.67 / $513.50 / $2,968.23	Professional		$246.67	$513.50	$2,968.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $58.28 / $76.09 / $505.24	Professional	26	$58.28	$76.09	$505.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $182.02 / $428.21 / $2,638.88	Professional	TC	$182.02	$428.21	$2,638.88
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $102.68 / $102.68 / $102.68	Professional	26	$102.68	$102.68	$102.68
United Facility/Professional Professional Modifier Low / Median / High Price $240.87 / $375.58 / $749.47	Professional		$240.87	$375.58	$749.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.57 / $71.29 / $119.59	Professional	26	$55.57	$71.29	$119.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $174.58 / $259.24 / $545.50	Professional	TC	$174.58	$259.24	$545.50