Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.20 / $66.34 / $117.51	Facility	26	$55.20	$66.34	$117.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.94 / $225.12 / $785.00	Professional		$143.94	$225.12	$785.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.60 / $63.78 / $218.23	Professional	26	$49.60	$63.78	$218.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $86.32 / $129.50 / $531.79	Professional	TC	$86.32	$129.50	$531.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.31 / $97.03 / $100.07	Professional		$94.31	$97.03	$100.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.04 / $57.20 / $81.20	Professional	26	$38.04	$57.20	$81.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.22 / $172.77 / $485.41	Professional		$133.22	$172.77	$485.41
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.87 / $68.51 / $113.90	Professional	26	$53.87	$68.51	$113.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.36 / $105.40 / $349.04	Professional	TC	$79.36	$105.40	$349.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.04 / $59.04 / $59.04	Facility	26	$59.04	$59.04	$59.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.97 / $220.73 / $440.84	Professional		$115.97	$220.73	$440.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.87 / $73.89 / $129.02	Professional	26	$44.87	$73.89	$129.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.23 / $139.71 / $323.31	Professional	TC	$73.23	$139.71	$323.31
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $373.44 / $482.96 / $482.96	Facility	26	$373.44	$482.96	$482.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $147.61 / $269.45 / $1,593.12	Professional		$147.61	$269.45	$1,593.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $54.35 / $74.84 / $325.83	Professional	26	$54.35	$74.84	$325.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $91.63 / $186.91 / $1,318.35	Professional	TC	$91.63	$186.91	$1,318.35
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $93.39 / $93.39 / $93.39	Professional	26	$93.39	$93.39	$93.39
United Facility/Professional Professional Modifier Low / Median / High Price $143.29 / $206.65 / $383.92	Professional		$143.29	$206.65	$383.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.89 / $65.98 / $119.95	Professional	26	$50.89	$65.98	$119.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.56 / $128.28 / $238.49	Professional	TC	$88.56	$128.28	$238.49