Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $100.00 / $281.84	Facility	26	$67.61	$100.00	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $275.42 / $870.96	Professional		$186.21	$275.42	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $77.62 / $269.15	Professional	26	$54.95	$77.62	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $190.55 / $457.09	Professional	TC	$128.82	$190.55	$457.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $147.91	Professional		$79.43	$79.43	$147.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $63.10 / $102.33	Professional	26	$43.65	$63.10	$102.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $204.17 / $204.17	Professional	TC	$204.17	$204.17	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $295.12 / $676.08	Professional		$208.93	$295.12	$676.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $83.18 / $134.90	Professional	26	$69.18	$83.18	$134.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $218.78 / $512.86	Professional	TC	$141.25	$218.78	$512.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $213.80 / $338.84	Professional		$204.17	$213.80	$338.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $69.18 / $97.72	Professional	26	$63.10	$69.18	$97.72
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $162.18 / $269.15	Professional	TC	$144.54	$162.18	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $331.13 / $645.65	Professional		$177.83	$331.13	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $85.11 / $162.18	Professional	26	$52.48	$85.11	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $239.88 / $524.81	Professional	TC	$128.82	$239.88	$524.81
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $426.58 / $549.54 / $549.54	Facility	26	$426.58	$549.54	$549.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $416.87 / $2,344.23	Professional		$223.87	$416.87	$2,344.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $95.50 / $537.03	Professional	26	$61.66	$95.50	$537.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $316.23 / $1,995.26	Professional	TC	$154.88	$316.23	$1,995.26
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $107.15 / $107.15	Professional	26	$107.15	$107.15	$107.15
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $199.53 / $234.42	Professional	TC	$199.53	$199.53	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $309.03 / $512.86	Professional		$208.93	$309.03	$512.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $77.62 / $131.83	Professional	26	$60.26	$77.62	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $213.80 / $389.05	Professional	TC	$147.91	$213.80	$389.05