Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.95 / $102.70 / $161.08	Facility	26	$83.95	$102.70	$161.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.32 / $475.00 / $1,562.76	Professional		$213.32	$475.00	$1,562.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.01 / $123.10 / $341.32	Professional	26	$67.01	$123.10	$341.32
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $117.72 / $158.80 / $628.48	Professional	52	$117.72	$158.80	$628.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $148.24 / $299.00 / $814.99	Professional	TC	$148.24	$299.00	$814.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.19 / $145.09 / $289.95	Professional		$139.19	$145.09	$289.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.07 / $73.11 / $104.73	Professional	26	$52.07	$73.11	$104.73
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $103.71 / $103.71 / $225.97	Professional	TC	$103.71	$103.71	$225.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $201.54 / $262.23 / $829.79	Professional		$201.54	$262.23	$829.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $73.66 / $95.14 / $153.66	Professional	26	$73.66	$95.14	$153.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $127.88 / $169.83 / $676.12	Professional	TC	$127.88	$169.83	$676.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.59 / $80.59 / $80.59	Facility	26	$80.59	$80.59	$80.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.08 / $344.92 / $799.40	Professional		$167.08	$344.92	$799.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.58 / $101.22 / $176.53	Professional	26	$61.58	$101.22	$176.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.02 / $223.08 / $680.64	Professional	TC	$109.02	$223.08	$680.64
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $510.16 / $659.84 / $659.84	Facility	26	$510.16	$659.84	$659.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $216.13 / $511.19 / $3,145.84	Professional		$216.13	$511.19	$3,145.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $72.50 / $104.02 / $577.89	Professional	26	$72.50	$104.02	$577.89
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $140.37 / $391.47 / $2,772.01	Professional	TC	$140.37	$391.47	$2,772.01
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $333.45 / $333.45 / $333.45	Professional		$333.45	$333.45	$333.45
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 $215.95 / $323.11 / $696.31	Professional		$215.95	$323.11	$696.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.54 / $88.76 / $165.37	Professional	26	$68.54	$88.76	$165.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.24 / $202.99 / $552.83	Professional	TC	$134.24	$202.99	$552.83