Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.20 / $92.90 / $145.88	Facility	26	$81.20	$92.90	$145.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $209.39 / $456.14 / $1,701.96	Professional		$209.39	$456.14	$1,701.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.23 / $140.00 / $394.26	Professional	26	$70.23	$140.00	$394.26
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $119.91 / $119.91 / $712.50	Professional	50	$119.91	$119.91	$712.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.87 / $335.00 / $972.99	Professional	TC	$229.87	$335.00	$972.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $127.42 / $194.56 / $334.85	Professional		$127.42	$194.56	$334.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.34 / $66.45 / $95.22	Professional	26	$47.34	$66.45	$95.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $236.93 / $372.08 / $813.54	Professional		$236.93	$372.08	$813.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.76 / $78.23 / $139.69	Professional	26	$66.76	$78.23	$139.69
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $355.39 / $558.12 / $1,220.31	Professional	50	$355.39	$558.12	$1,220.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $170.17 / $282.76 / $673.85	Professional	TC	$170.17	$282.76	$673.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.95 / $72.95	Facility	26	$72.95	$72.95	$72.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.29 / $404.87 / $832.18	Professional		$194.29	$404.87	$832.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.70 / $91.22 / $159.19	Professional	26	$55.70	$91.22	$159.19
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $338.09 / $338.09 / $338.09	Professional	50	$338.09	$338.09	$338.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $143.05 / $313.89 / $724.23	Professional	TC	$143.05	$313.89	$724.23
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $463.68 / $596.96 / $596.96	Facility	26	$463.68	$596.96	$596.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $259.31 / $514.04 / $2,789.74	Professional		$259.31	$514.04	$2,789.74
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $65.77 / $94.17 / $531.65	Professional	26	$65.77	$94.17	$531.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $189.46 / $399.32 / $2,459.04	Professional	TC	$189.46	$399.32	$2,459.04
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $385.08 / $385.08 / $385.08	Professional		$385.08	$385.08	$385.08
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $116.00 / $116.00 / $116.00	Professional	26	$116.00	$116.00	$116.00
United Facility/Professional Professional Modifier Low / Median / High Price $223.47 / $378.76 / $786.13	Professional		$223.47	$378.76	$786.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.09 / $80.38 / $137.86	Professional	26	$64.09	$80.38	$137.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $185.43 / $274.79 / $589.39	Professional	TC	$185.43	$274.79	$589.39