Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $125.89 / $338.84	Facility	26	$97.72	$125.89	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $436.52 / $1,445.44	Professional		$199.53	$436.52	$1,445.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $112.20 / $302.00	Professional	26	$66.07	$112.20	$302.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $123.03 / $199.53 / $870.96	Professional	52	$123.03	$199.53	$870.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $245.47 / $676.08	Professional	TC	$123.03	$245.47	$676.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $144.54 / $288.40	Professional		$138.04	$144.54	$288.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $69.18 / $114.82	Professional	26	$52.48	$69.18	$114.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $93.33 / $213.80	Professional	TC	$79.43	$93.33	$213.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $257.04 / $794.33	Professional		$199.53	$257.04	$794.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $93.33 / $158.49	Professional	26	$74.13	$93.33	$158.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $165.96 / $630.96	Professional	TC	$128.82	$165.96	$630.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $208.93 / $323.59	Professional		$199.53	$208.93	$323.59
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $83.18 / $114.82	Professional	26	$74.13	$83.18	$114.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $131.83 / $208.93	Professional	TC	$125.89	$131.83	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $346.74 / $758.58	Professional		$173.78	$346.74	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $102.33 / $186.21	Professional	26	$63.10	$102.33	$186.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $223.87 / $616.60	Professional	TC	$114.82	$223.87	$616.60
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $512.86 / $660.69 / $660.69	Facility	26	$512.86	$660.69	$660.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $489.78 / $2,884.03	Professional		$199.53	$489.78	$2,884.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $107.15 / $562.34	Professional	26	$69.18	$107.15	$562.34
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $354.81 / $2,511.89	Professional	TC	$128.82	$354.81	$2,511.89
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $331.13	Professional		$165.96	$165.96	$331.13
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $128.82 / $128.82	Professional	26	$128.82	$128.82	$128.82
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $204.17 / $208.93	Professional	TC	$204.17	$204.17	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $295.12 / $645.65	Professional		$199.53	$295.12	$645.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $87.10 / $144.54	Professional	26	$67.61	$87.10	$144.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $181.97 / $501.19	Professional	TC	$125.89	$181.97	$501.19