Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.51 / $123.38 / $203.00	Facility	26	$102.51	$123.38	$203.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $271.69 / $328.65 / $1,361.31	Professional		$271.69	$328.65	$1,361.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.48 / $102.51 / $444.00	Professional	26	$87.48	$102.51	$444.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $219.77 / $219.77 / $219.77	Professional	50	$219.77	$219.77	$219.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $176.33 / $220.14 / $975.16	Professional	TC	$176.33	$220.14	$975.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.04 / $93.09 / $147.34	Professional	26	$66.04	$93.09	$147.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $267.20 / $366.50 / $784.11	Professional		$267.20	$366.50	$784.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.00 / $109.23 / $198.89	Professional	26	$93.00	$109.23	$198.89
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $400.80 / $549.75 / $1,176.16	Professional	50	$400.80	$549.75	$1,176.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $173.95 / $263.93 / $606.35	Professional	TC	$173.95	$263.93	$606.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.96 / $101.96 / $101.96	Facility	26	$101.96	$101.96	$101.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $290.20 / $493.24 / $866.03	Professional		$290.20	$493.24	$866.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.84 / $127.08 / $223.53	Professional	26	$77.84	$127.08	$223.53
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $458.57 / $458.57 / $458.57	Professional	50	$458.57	$458.57	$458.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.89 / $362.28 / $664.17	Professional	TC	$208.89	$362.28	$664.17
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $649.67 / $833.76 / $833.76	Facility	26	$649.67	$833.76	$833.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $360.90 / $537.01 / $2,878.66	Professional		$360.90	$537.01	$2,878.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $94.56 / $128.25 / $561.99	Professional	26	$94.56	$128.25	$561.99
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $258.06 / $423.84 / $2,400.63	Professional	TC	$258.06	$423.84	$2,400.63
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $162.13 / $162.13 / $162.13	Professional	26	$162.13	$162.13	$162.13
United Facility/Professional Professional Modifier Low / Median / High Price $349.24 / $469.17 / $817.92	Professional		$349.24	$469.17	$817.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $112.08 / $209.35	Professional	26	$91.20	$112.08	$209.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $253.44 / $335.23 / $596.78	Professional	TC	$253.44	$335.23	$596.78