Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.33 / $60.34 / $97.90	Facility	26	$52.33	$60.34	$97.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.97 / $247.93 / $872.99	Professional		$139.97	$247.93	$872.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.92 / $55.00 / $236.00	Professional	26	$44.92	$55.00	$236.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.09 / $159.68 / $598.58	Professional	TC	$90.09	$159.68	$598.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.33 / $196.49 / $196.49	Professional		$94.33	$196.49	$196.49
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 $70.61 / $70.61 / $70.61	Professional	TC	$70.61	$70.61	$70.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.78 / $190.02 / $498.13	Professional		$146.78	$190.02	$498.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.69 / $64.45 / $120.51	Professional	26	$49.69	$64.45	$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 $112.44 / $230.96 / $450.00	Professional		$112.44	$230.96	$450.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.27 / $68.11 / $118.33	Professional	26	$41.27	$68.11	$118.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.52 / $159.16 / $340.70	Professional	TC	$73.52	$159.16	$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 $157.35 / $278.13 / $1,609.32	Professional		$157.35	$278.13	$1,609.32
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.10 / $69.92 / $379.76	Professional	26	$51.10	$69.92	$379.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $105.79 / $212.20 / $1,345.00	Professional	TC	$105.79	$212.20	$1,345.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $225.96 / $225.96 / $225.96	Professional		$225.96	$225.96	$225.96
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $85.61 / $85.61 / $85.61	Professional	26	$85.61	$85.61	$85.61
United Facility/Professional Professional Modifier Low / Median / High Price $152.56 / $216.48 / $387.76	Professional		$152.56	$216.48	$387.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.47 / $60.85 / $102.50	Professional	26	$50.47	$60.85	$102.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.52 / $148.54 / $262.75	Professional	TC	$100.52	$148.54	$262.75