Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $83.10 / $135.79	Facility	26	$63.10	$83.10	$135.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $214.24 / $298.85 / $1,193.27	Professional		$214.24	$298.85	$1,193.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.34 / $72.90 / $273.67	Professional	26	$59.34	$72.90	$273.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $145.94 / $220.00 / $906.61	Professional	TC	$145.94	$220.00	$906.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.66 / $141.03 / $328.95	Professional		$92.66	$141.03	$328.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.86 / $61.57 / $84.05	Professional	26	$43.86	$61.57	$84.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $211.26 / $303.54 / $717.21	Professional		$211.26	$303.54	$717.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.45 / $84.50 / $143.22	Professional	26	$68.45	$84.50	$143.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $142.80 / $219.03 / $589.63	Professional	TC	$142.80	$219.03	$589.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.54 / $67.54 / $67.54	Facility	26	$67.54	$67.54	$67.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.47 / $336.24 / $650.55	Professional		$170.47	$336.24	$650.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.93 / $88.68 / $157.07	Professional	26	$51.93	$88.68	$157.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $122.74 / $248.19 / $528.17	Professional	TC	$122.74	$248.19	$528.17
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $429.60 / $553.04 / $553.04	Facility	26	$429.60	$553.04	$553.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $235.67 / $423.18 / $2,319.03	Professional		$235.67	$423.18	$2,319.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $68.16 / $93.57 / $543.21	Professional	26	$68.16	$93.57	$543.21
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $164.81 / $317.70 / $1,973.17	Professional	TC	$164.81	$317.70	$1,973.17
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $107.34 / $107.34 / $107.34	Professional	26	$107.34	$107.34	$107.34
United Facility/Professional Professional Modifier Low / Median / High Price $229.07 / $321.62 / $536.48	Professional		$229.07	$321.62	$536.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.87 / $83.57 / $140.74	Professional	26	$64.87	$83.57	$140.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.66 / $220.97 / $400.55	Professional	TC	$158.66	$220.97	$400.55