Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.21 / $60.34 / $97.90	Facility	26	$50.21	$60.34	$97.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.44 / $247.93 / $833.70	Professional		$141.44	$247.93	$833.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.61 / $54.62 / $227.28	Professional	26	$43.61	$54.62	$227.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.23 / $160.94 / $617.44	Professional	TC	$90.23	$160.94	$617.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.03 / $197.45 / $219.23	Professional		$105.03	$197.45	$219.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.88 / $48.98 / $70.17	Professional	26	$34.88	$48.98	$70.17
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $71.17 / $123.01 / $123.01	Professional	TC	$71.17	$123.01	$123.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $149.91 / $193.86 / $498.13	Professional		$149.91	$193.86	$498.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.84 / $65.61 / $120.51	Professional	26	$52.84	$65.61	$120.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.08 / $125.80 / $376.80	Professional	TC	$97.08	$125.80	$376.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.27 / $231.82 / $450.00	Professional		$113.27	$231.82	$450.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.32 / $68.11 / $126.56	Professional	26	$41.32	$68.11	$126.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.38 / $160.24 / $340.70	Professional	TC	$74.38	$160.24	$340.70
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $341.52 / $442.24 / $442.24	Facility	26	$341.52	$442.24	$442.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $158.07 / $284.22 / $1,609.32	Professional		$158.07	$284.22	$1,609.32
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.25 / $71.75 / $379.76	Professional	26	$51.25	$71.75	$379.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $106.51 / $213.64 / $1,331.00	Professional	TC	$106.51	$213.64	$1,331.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $227.07 / $227.07 / $227.07	Professional		$227.07	$227.07	$227.07
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $85.61 / $85.61 / $85.61	Professional	26	$85.61	$85.61	$85.61
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $141.46 / $141.46 / $141.46	Professional	TC	$141.46	$141.46	$141.46
United Facility/Professional Professional Modifier Low / Median / High Price $153.12 / $221.30 / $376.51	Professional		$153.12	$221.30	$376.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.86 / $62.50 / $109.09	Professional	26	$49.86	$62.50	$109.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.32 / $152.32 / $262.88	Professional	TC	$96.32	$152.32	$262.88