Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.18 / $70.04 / $124.49	Facility	26	$63.18	$70.04	$124.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.45 / $253.52 / $833.70	Professional		$204.45	$253.52	$833.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.18 / $67.92 / $235.13	Professional	26	$53.18	$67.92	$235.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $153.71 / $189.32 / $657.01	Professional	TC	$153.71	$189.32	$657.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $334.63 / $334.63 / $334.63	Professional		$334.63	$334.63	$334.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.56 / $57.02 / $81.68	Professional	26	$40.56	$57.02	$81.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $201.42 / $261.82 / $564.41	Professional		$201.42	$261.82	$564.41
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 $143.74 / $190.90 / $457.13	Professional	TC	$143.74	$190.90	$457.13
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 $174.16 / $306.29 / $531.52	Professional		$174.16	$306.29	$531.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.87 / $78.34 / $137.35	Professional	26	$47.87	$78.34	$137.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $130.18 / $231.19 / $413.85	Professional	TC	$130.18	$231.19	$413.85
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 $225.33 / $330.48 / $1,627.19	Professional		$225.33	$330.48	$1,627.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $57.50 / $79.70 / $345.18	Professional	26	$57.50	$79.70	$345.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $164.58 / $259.73 / $1,330.47	Professional	TC	$164.58	$259.73	$1,330.47
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 $219.03 / $297.35 / $480.11	Professional		$219.03	$297.35	$480.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.33 / $68.09 / $118.38	Professional	26	$52.33	$68.09	$118.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $161.36 / $220.66 / $427.02	Professional	TC	$161.36	$220.66	$427.02