Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.95 / $102.13 / $149.50	Facility	26	$83.95	$102.13	$149.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $212.91 / $475.00 / $1,446.20	Professional		$212.91	$475.00	$1,446.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.75 / $126.00 / $318.23	Professional	26	$66.75	$126.00	$318.23
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $117.33 / $158.55 / $318.23	Professional	52	$117.33	$158.55	$318.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.07 / $225.77 / $812.95	Professional	TC	$140.07	$225.77	$812.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.23 / $143.00 / $289.00	Professional		$101.23	$143.00	$289.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.06 / $73.11 / $104.73	Professional	26	$52.06	$73.11	$104.73
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $103.16 / $220.00 / $220.00	Professional	TC	$103.16	$220.00	$220.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $201.23 / $263.42 / $841.30	Professional		$201.23	$263.42	$841.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $73.66 / $95.14 / $165.43	Professional	26	$73.66	$95.14	$165.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $127.56 / $169.41 / $675.89	Professional	TC	$127.56	$169.41	$675.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.26 / $80.26 / $80.26	Facility	26	$80.26	$80.26	$80.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.53 / $344.37 / $788.72	Professional		$166.53	$344.37	$788.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.99 / $103.36 / $184.60	Professional	26	$61.99	$103.36	$184.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.73 / $222.50 / $653.04	Professional	TC	$108.73	$222.50	$653.04
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $510.16 / $656.72 / $656.72	Facility	26	$510.16	$656.72	$656.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $217.50 / $496.53 / $2,901.82	Professional		$217.50	$496.53	$2,901.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $75.45 / $105.64 / $558.07	Professional	26	$75.45	$105.64	$558.07
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $140.02 / $389.77 / $2,498.98	Professional	TC	$140.02	$389.77	$2,498.98
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $332.35 / $332.35 / $332.35	Professional		$332.35	$332.35	$332.35
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $127.47 / $127.47 / $127.47	Professional	26	$127.47	$127.47	$127.47
United Facility/Professional Professional Modifier Low / Median / High Price $209.48 / $296.72 / $694.00	Professional		$209.48	$296.72	$694.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.59 / $92.32 / $152.30	Professional	26	$71.59	$92.32	$152.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $135.34 / $202.10 / $505.58	Professional	TC	$135.34	$202.10	$505.58