Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.14 / $74.53 / $115.63	Facility	26	$59.14	$74.53	$115.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.38 / $267.30 / $1,053.00	Professional		$151.38	$267.30	$1,053.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.71 / $68.31 / $230.44	Professional	26	$51.71	$68.31	$230.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $117.00 / $204.79 / $721.58	Professional	TC	$117.00	$204.79	$721.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.82 / $70.42 / $280.39	Professional		$58.82	$70.42	$280.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.84 / $57.36 / $82.17	Professional	26	$40.84	$57.36	$82.17
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.22 / $40.22 / $206.00	Professional	TC	$40.22	$40.22	$206.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $178.49 / $253.58 / $614.60	Professional		$178.49	$253.58	$614.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.50 / $76.30 / $128.58	Professional	26	$61.50	$76.30	$128.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $116.99 / $177.29 / $481.84	Professional	TC	$116.99	$177.29	$481.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.24 / $63.24 / $63.24	Facility	26	$63.24	$63.24	$63.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $145.28 / $280.18 / $541.00	Professional		$145.28	$280.18	$541.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.16 / $81.72 / $145.88	Professional	26	$48.16	$81.72	$145.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.16 / $203.00 / $418.37	Professional	TC	$100.16	$203.00	$418.37
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $400.16 / $518.00 / $518.00	Facility	26	$400.16	$518.00	$518.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $196.09 / $343.91 / $1,890.30	Professional		$196.09	$343.91	$1,890.30
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $61.44 / $84.51 / $450.76	Professional	26	$61.44	$84.51	$450.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $134.94 / $257.13 / $1,576.92	Professional	TC	$134.94	$257.13	$1,576.92
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $100.12 / $100.12 / $100.12	Professional	26	$100.12	$100.12	$100.12
United Facility/Professional Professional Modifier Low / Median / High Price $192.94 / $278.89 / $453.22	Professional		$192.94	$278.89	$453.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.10 / $75.83 / $127.76	Professional	26	$59.10	$75.83	$127.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $129.99 / $185.63 / $325.02	Professional	TC	$129.99	$185.63	$325.02