Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.18 / $70.66 / $116.97	Facility	26	$63.18	$70.66	$116.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.15 / $299.31 / $1,183.00	Professional		$240.15	$299.31	$1,183.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.18 / $71.00 / $258.72	Professional	26	$53.18	$71.00	$258.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $176.19 / $220.00 / $684.26	Professional	TC	$176.19	$220.00	$684.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.60 / $199.60 / $199.60	Professional		$199.60	$199.60	$199.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.56 / $57.02 / $86.57	Professional	26	$40.56	$57.02	$86.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $211.06 / $274.61 / $599.28	Professional		$211.06	$274.61	$599.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.68 / $73.70 / $120.51	Professional	26	$57.68	$73.70	$120.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $153.38 / $203.70 / $458.84	Professional	TC	$153.38	$203.70	$458.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.89 / $62.89 / $62.89	Facility	26	$62.89	$62.89	$62.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.01 / $334.35 / $534.00	Professional		$192.01	$334.35	$534.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.91 / $78.31 / $137.35	Professional	26	$47.91	$78.31	$137.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $146.02 / $258.08 / $425.48	Professional	TC	$146.02	$258.08	$425.48
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $397.76 / $514.88 / $514.88	Facility	26	$397.76	$514.88	$514.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $243.16 / $347.03 / $1,817.09	Professional		$243.16	$347.03	$1,817.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $57.88 / $79.70 / $364.90	Professional	26	$57.88	$79.70	$364.90
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $184.73 / $276.69 / $1,526.12	Professional	TC	$184.73	$276.69	$1,526.12
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $99.56 / $99.56 / $99.56	Professional	26	$99.56	$99.56	$99.56
United Facility/Professional Professional Modifier Low / Median / High Price $229.75 / $297.82 / $491.54	Professional		$229.75	$297.82	$491.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.68 / $71.03 / $138.16	Professional	26	$55.68	$71.03	$138.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $167.92 / $224.37 / $400.02	Professional	TC	$167.92	$224.37	$400.02