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 / $125.19	Facility	26	$63.18	$70.66	$125.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.97 / $255.77 / $833.70	Professional		$168.97	$255.77	$833.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.18 / $67.92 / $277.00	Professional	26	$53.18	$67.92	$277.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $215.99 / $657.01	Professional	TC	$119.70	$215.99	$657.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $126.00 / $126.00 / $126.00	Professional		$126.00	$126.00	$126.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.56 / $52.84 / $81.68	Professional	26	$40.56	$52.84	$81.68
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $256.75 / $256.75 / $256.75	Professional	TC	$256.75	$256.75	$256.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $203.91 / $260.29 / $568.12	Professional		$203.91	$260.29	$568.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.68 / $73.70 / $121.22	Professional	26	$57.68	$73.70	$121.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $146.22 / $187.08 / $460.21	Professional	TC	$146.22	$187.08	$460.21
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 $145.00 / $277.32 / $517.38	Professional		$145.00	$277.32	$517.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.04 / $78.31 / $137.88	Professional	26	$48.04	$78.31	$137.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.16 / $206.25 / $399.60	Professional	TC	$100.16	$206.25	$399.60
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 $196.69 / $316.74 / $1,638.03	Professional		$196.69	$316.74	$1,638.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $57.88 / $79.70 / $376.34	Professional	26	$57.88	$79.70	$376.34
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $137.50 / $246.53 / $1,335.34	Professional	TC	$137.50	$246.53	$1,335.34
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 $190.39 / $274.62 / $480.84	Professional		$190.39	$274.62	$480.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.68 / $69.02 / $129.49	Professional	26	$55.68	$69.02	$129.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.12 / $186.16 / $328.29	Professional	TC	$123.12	$186.16	$328.29