Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.33 / $60.34 / $97.90	Facility	26	$52.33	$60.34	$97.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.82 / $162.41 / $688.49	Professional		$48.82	$162.41	$688.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.54 / $60.40 / $246.46	Professional	26	$45.54	$60.40	$246.46
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $112.22 / $196.90 / $300.22	Professional	50	$112.22	$196.90	$300.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.09 / $160.31 / $549.70	Professional	TC	$90.09	$160.31	$549.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.81 / $98.32 / $196.97	Professional		$68.81	$98.32	$196.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.88 / $48.98 / $70.17	Professional	26	$34.88	$48.98	$70.17
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $70.89 / $70.89 / $70.89	Professional	TC	$70.89	$70.89	$70.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.78 / $190.02 / $436.47	Professional		$146.78	$190.02	$436.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.69 / $63.94 / $113.08	Professional	26	$49.69	$63.94	$113.08
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $220.17 / $285.02 / $654.70	Professional	50	$220.17	$285.02	$654.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.08 / $125.80 / $335.70	Professional	TC	$97.08	$125.80	$335.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.72 / $230.96 / $429.12	Professional		$112.72	$230.96	$429.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.32 / $67.76 / $124.66	Professional	26	$41.32	$67.76	$124.66
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $231.80 / $231.80 / $231.80	Professional	50	$231.80	$231.80	$231.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.81 / $159.16 / $321.74	Professional	TC	$73.81	$159.16	$321.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $341.52 / $442.24 / $442.24	Facility	26	$341.52	$442.24	$442.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $157.35 / $262.27 / $1,378.78	Professional		$157.35	$262.27	$1,378.78
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.10 / $69.00 / $300.10	Professional	26	$51.10	$69.00	$300.10
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $105.79 / $198.23 / $1,332.00	Professional	TC	$105.79	$198.23	$1,332.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $226.52 / $226.52 / $226.52	Professional		$226.52	$226.52	$226.52
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $85.61 / $85.61 / $85.61	Professional	26	$85.61	$85.61	$85.61
United Facility/Professional Professional Modifier Low / Median / High Price $145.41 / $196.60 / $364.87	Professional		$145.41	$196.60	$364.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.86 / $61.50 / $119.68	Professional	26	$49.86	$61.50	$119.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.90 / $152.46 / $249.87	Professional	TC	$100.90	$152.46	$249.87