Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.35 / $63.36 / $108.07	Facility	26	$47.35	$63.36	$108.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.97 / $221.75 / $833.70	Professional		$134.97	$221.75	$833.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.88 / $58.94 / $201.04	Professional	26	$46.88	$58.94	$201.04
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $69.06 / $83.68 / $140.38	Professional	52	$69.06	$83.68	$140.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $86.32 / $177.61 / $586.08	Professional	TC	$86.32	$177.61	$586.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.42 / $100.87 / $116.89	Professional		$76.42	$100.87	$116.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.88 / $52.01 / $76.17	Professional	26	$37.88	$52.01	$76.17
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $70.33 / $70.33 / $151.00	Professional	TC	$70.33	$70.33	$151.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $145.13 / $191.88 / $492.35	Professional		$145.13	$191.88	$492.35
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.68 / $69.70 / $120.51	Professional	26	$57.68	$69.70	$120.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.44 / $122.30 / $349.04	Professional	TC	$87.44	$122.30	$349.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.64 / $58.64 / $58.64	Facility	26	$58.64	$58.64	$58.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.94 / $226.32 / $450.00	Professional		$115.94	$226.32	$450.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.57 / $70.76 / $127.24	Professional	26	$44.57	$70.76	$127.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.52 / $152.13 / $340.70	Professional	TC	$73.52	$152.13	$340.70
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $371.04 / $479.84 / $479.84	Facility	26	$371.04	$479.84	$479.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $157.13 / $278.95 / $1,609.32	Professional		$157.13	$278.95	$1,609.32
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $55.01 / $76.95 / $394.61	Professional	26	$55.01	$76.95	$394.61
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $101.12 / $198.54 / $1,384.00	Professional	TC	$101.12	$198.54	$1,384.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $92.75 / $92.75 / $92.75	Professional	26	$92.75	$92.75	$92.75
United Facility/Professional Professional Modifier Low / Median / High Price $155.78 / $224.84 / $383.89	Professional		$155.78	$224.84	$383.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.27 / $68.70 / $129.49	Professional	26	$53.27	$68.70	$129.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.27 / $141.97 / $260.06	Professional	TC	$91.27	$141.97	$260.06