Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $177.83 / $426.58	Facility	26	$117.49	$177.83	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $446.68 / $1,412.54	Professional		$275.42	$446.68	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $138.04 / $309.03	Professional	26	$83.18	$138.04	$309.03
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $288.40 / $588.84 / $812.83	Professional	52	$288.40	$588.84	$812.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $302.00 / $660.69	Professional	TC	$190.55	$302.00	$660.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $66.07 / $104.71	Professional	26	$63.10	$66.07	$104.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $131.83 / $134.90	Professional	TC	$131.83	$131.83	$134.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $363.08 / $954.99	Professional		$281.84	$363.08	$954.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $112.20 / $181.97	Professional	26	$89.13	$112.20	$181.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $257.04 / $776.25	Professional	TC	$194.98	$257.04	$776.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $316.23 / $457.09	Professional		$281.84	$316.23	$457.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $91.20 / $134.90	Professional	26	$89.13	$91.20	$134.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $204.17 / $316.23	Professional	TC	$194.98	$204.17	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $446.68 / $954.99	Professional		$245.47	$446.68	$954.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $120.23 / $213.80	Professional	26	$74.13	$120.23	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $316.23 / $776.25	Professional	TC	$177.83	$316.23	$776.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $616.60 / $794.33 / $794.33	Facility	26	$616.60	$794.33	$794.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $616.60 / $3,467.37	Professional		$281.84	$616.60	$3,467.37
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $125.89 / $676.08	Professional	26	$79.43	$125.89	$676.08
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $478.63 / $3,019.95	Professional	TC	$199.53	$478.63	$3,019.95
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $416.87 / $776.25	Professional		$281.84	$416.87	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $102.33 / $173.78	Professional	26	$79.43	$102.33	$173.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $281.84 / $630.96	Professional	TC	$194.98	$281.84	$630.96