Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $177.83 / $426.58	Facility	26	$117.49	$177.83	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $426.58 / $1,230.27	Professional		$275.42	$426.58	$1,230.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $134.90 / $371.54	Professional	26	$83.18	$134.90	$371.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $302.00 / $616.60	Professional	TC	$190.55	$302.00	$616.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $81.28 / $141.25	Professional	26	$63.10	$81.28	$141.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $363.08 / $954.99	Professional		$288.40	$363.08	$954.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $112.20 / $181.97	Professional	26	$89.13	$112.20	$181.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $257.04 / $758.58	Professional	TC	$199.53	$257.04	$758.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $295.12 / $446.68	Professional		$281.84	$295.12	$446.68
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $100.00 / $141.25	Professional	26	$89.13	$100.00	$141.25
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $204.17 / $302.00	Professional	TC	$194.98	$204.17	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $446.68 / $954.99	Professional		$245.47	$446.68	$954.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $120.23 / $213.80	Professional	26	$74.13	$120.23	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $323.59 / $776.25	Professional	TC	$177.83	$323.59	$776.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $616.60 / $794.33 / $794.33	Facility	26	$616.60	$794.33	$794.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $616.60 / $3,467.37	Professional		$281.84	$616.60	$3,467.37
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $128.82 / $660.69	Professional	26	$79.43	$128.82	$660.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $478.63 / $3,019.95	Professional	TC	$199.53	$478.63	$3,019.95
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $416.87 / $776.25	Professional		$281.84	$416.87	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $102.33 / $173.78	Professional	26	$79.43	$102.33	$173.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $281.84 / $630.96	Professional	TC	$194.98	$281.84	$630.96