Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.96 / $96.76 / $158.78	Facility	26	$87.96	$96.76	$158.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $314.62 / $475.00 / $1,542.43	Professional		$314.62	$475.00	$1,542.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.97 / $140.00 / $391.75	Professional	26	$85.97	$140.00	$391.75
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $140.86 / $191.59 / $237.50	Professional	52	$140.86	$191.59	$237.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $230.33 / $306.76 / $972.99	Professional	TC	$230.33	$306.76	$972.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.41 / $343.70 / $343.70	Professional		$165.41	$343.70	$343.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.18 / $72.06 / $103.24	Professional	26	$51.18	$72.06	$103.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $244.63 / $378.89 / $824.97	Professional		$244.63	$378.89	$824.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.27 / $84.74 / $150.68	Professional	26	$72.27	$84.74	$150.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $172.35 / $284.31 / $674.29	Professional	TC	$172.35	$284.31	$674.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.45 / $79.45 / $79.45	Facility	26	$79.45	$79.45	$79.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $418.82 / $848.16	Professional		$199.53	$418.82	$848.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.70 / $98.85 / $171.71	Professional	26	$60.70	$98.85	$171.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $143.33 / $318.00 / $731.71	Professional	TC	$143.33	$318.00	$731.71
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $502.88 / $650.32 / $650.32	Facility	26	$502.88	$650.32	$650.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $268.01 / $522.49 / $3,507.01	Professional		$268.01	$522.49	$3,507.01
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $71.09 / $102.54 / $571.29	Professional	26	$71.09	$102.54	$571.29
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $191.93 / $401.36 / $2,477.29	Professional	TC	$191.93	$401.36	$2,477.29
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $395.26 / $395.26 / $395.26	Professional		$395.26	$395.26	$395.26
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $125.63 / $125.63 / $125.63	Professional	26	$125.63	$125.63	$125.63
United Facility/Professional Professional Modifier Low / Median / High Price $261.77 / $388.10 / $761.91	Professional		$261.77	$388.10	$761.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.15 / $87.97 / $230.02	Professional	26	$69.15	$87.97	$230.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $187.87 / $273.33 / $592.69	Professional	TC	$187.87	$273.33	$592.69