Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.69 / $93.37 / $142.25	Facility	26	$76.69	$93.37	$142.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $142.99 / $337.39 / $1,336.35	Professional		$142.99	$337.39	$1,336.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.73 / $140.00 / $374.22	Professional	26	$67.73	$140.00	$374.22
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $475.00 / $475.00 / $475.00	Professional	50	$475.00	$475.00	$475.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $124.11 / $167.06 / $237.50	Professional	52	$124.11	$167.06	$237.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $176.33 / $335.00 / $942.38	Professional	TC	$176.33	$335.00	$942.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $116.89 / $153.77 / $306.75	Professional		$116.89	$153.77	$306.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.56 / $66.80 / $95.69	Professional	26	$47.56	$66.80	$95.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $119.03 / $119.03 / $252.00	Professional	TC	$119.03	$119.03	$252.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $211.47 / $276.51 / $813.63	Professional		$211.47	$276.51	$813.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.38 / $86.65 / $139.69	Professional	26	$67.38	$86.65	$139.69
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $317.20 / $414.76 / $1,220.44	Professional	50	$317.20	$414.76	$1,220.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.09 / $191.35 / $673.95	Professional	TC	$144.09	$191.35	$673.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.64 / $73.64 / $73.64	Facility	26	$73.64	$73.64	$73.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $176.52 / $361.03 / $807.19	Professional		$176.52	$361.03	$807.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.28 / $91.01 / $160.43	Professional	26	$56.28	$91.01	$160.43
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $301.29 / $301.29 / $301.29	Professional	50	$301.29	$301.29	$301.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $124.17 / $244.71 / $707.57	Professional	TC	$124.17	$244.71	$707.57
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $466.08 / $603.28 / $603.28	Facility	26	$466.08	$603.28	$603.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $228.50 / $474.75 / $2,791.06	Professional		$228.50	$474.75	$2,791.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $65.77 / $96.94 / $525.38	Professional	26	$65.77	$96.94	$525.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $158.22 / $353.91 / $2,451.15	Professional	TC	$158.22	$353.91	$2,451.15
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $352.76 / $352.76 / $352.76	Professional		$352.76	$352.76	$352.76
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $116.55 / $116.55 / $116.55	Professional	26	$116.55	$116.55	$116.55
United Facility/Professional Professional Modifier Low / Median / High Price $225.19 / $313.77 / $736.33	Professional		$225.19	$313.77	$736.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.25 / $80.76 / $138.58	Professional	26	$61.25	$80.76	$138.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $152.68 / $228.38 / $563.44	Professional	TC	$152.68	$228.38	$563.44