Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $125.89 / $338.84	Facility	26	$85.11	$125.89	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $426.58 / $1,584.89	Professional		$199.53	$426.58	$1,584.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $120.23 / $331.13	Professional	26	$64.57	$120.23	$331.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $223.87 / $537.03	Professional	TC	$123.03	$223.87	$537.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $141.25 / $257.04	Professional		$70.79	$141.25	$257.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $72.44 / $114.82	Professional	26	$52.48	$72.44	$114.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $95.50 / $102.33	Professional	TC	$95.50	$95.50	$102.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $257.04 / $831.76	Professional		$199.53	$257.04	$831.76
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 / $645.65	Professional	TC	$128.82	$165.96	$645.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $223.87 / $323.59	Professional		$199.53	$223.87	$323.59
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $75.86 / $114.82	Professional	26	$74.13	$75.86	$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 / $794.33	Professional		$173.78	$346.74	$794.33
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 / $660.69	Professional	TC	$114.82	$223.87	$660.69
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 $204.17 / $512.86 / $3,162.28	Professional		$204.17	$512.86	$3,162.28
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $107.15 / $602.56	Professional	26	$67.61	$107.15	$602.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $354.81 / $2,754.23	Professional	TC	$128.82	$354.81	$2,754.23
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $338.84 / $338.84	Professional		$165.96	$338.84	$338.84
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 / $204.17	Professional	TC	$204.17	$204.17	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $295.12 / $676.08	Professional		$199.53	$295.12	$676.08
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 / $524.81	Professional	TC	$125.89	$181.97	$524.81