Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.84 / $65.91 / $116.72	Facility	26	$54.84	$65.91	$116.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.47 / $161.87 / $364.32	Professional		$139.47	$161.87	$364.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.28 / $63.36 / $149.31	Professional	26	$48.28	$63.36	$149.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.39 / $102.93 / $220.00	Professional	TC	$88.39	$102.93	$220.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.35 / $104.55 / $116.74	Professional		$97.35	$104.55	$116.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.88 / $56.82 / $76.17	Professional	26	$37.88	$56.82	$76.17
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $62.41 / $62.41 / $153.93	Professional	TC	$62.41	$62.41	$153.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.96 / $162.62 / $287.33	Professional		$133.96	$162.62	$287.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.72 / $59.17 / $106.61	Professional	26	$50.72	$59.17	$106.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.23 / $99.88 / $176.80	Professional	TC	$83.23	$99.88	$176.80
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 $121.51 / $196.42 / $286.64	Professional		$121.51	$196.42	$286.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.57 / $73.06 / $121.45	Professional	26	$44.57	$73.06	$121.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.72 / $125.17 / $195.45	Professional	TC	$76.72	$125.17	$195.45
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 $153.01 / $187.47 / $915.52	Professional		$153.01	$187.47	$915.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $53.89 / $66.47 / $323.73	Professional	26	$53.89	$66.47	$323.73
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $95.28 / $121.44 / $591.79	Professional	TC	$95.28	$121.44	$591.79
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 $142.26 / $181.60 / $318.43	Professional		$142.26	$181.60	$318.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.97 / $65.22 / $126.35	Professional	26	$50.97	$65.22	$126.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.21 / $116.11 / $207.14	Professional	TC	$93.21	$116.11	$207.14