Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.95 / $125.96 / $177.09	Facility	26	$91.95	$125.96	$177.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $384.64 / $475.00 / $2,073.69	Professional		$384.64	$475.00	$2,073.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.70 / $140.00 / $461.87	Professional	26	$96.70	$140.00	$461.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $289.26 / $359.58 / $931.29	Professional	TC	$289.26	$359.58	$931.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $271.72 / $467.97 / $467.97	Professional		$271.72	$467.97	$467.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.02 / $80.09 / $128.11	Professional	26	$57.02	$80.09	$128.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $335.70 / $418.74 / $949.61	Professional		$335.70	$418.74	$949.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $80.58 / $94.49 / $168.30	Professional	26	$80.58	$94.49	$168.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $255.13 / $335.53 / $822.89	Professional	TC	$255.13	$335.53	$822.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.95 / $87.95 / $87.95	Facility	26	$87.95	$87.95	$87.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $272.37 / $510.83 / $936.52	Professional		$272.37	$510.83	$936.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.19 / $109.83 / $191.47	Professional	26	$67.19	$109.83	$191.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $211.71 / $405.36 / $791.71	Professional	TC	$211.71	$405.36	$791.71
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $558.79 / $720.40 / $720.40	Facility	26	$558.79	$720.40	$720.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $366.35 / $615.83 / $3,348.15	Professional		$366.35	$615.83	$3,348.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $78.92 / $114.36 / $597.70	Professional	26	$78.92	$114.36	$597.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $279.13 / $515.23 / $2,941.88	Professional	TC	$279.13	$515.23	$2,941.88
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $538.16 / $538.16 / $538.16	Professional		$538.16	$538.16	$538.16
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $139.79 / $139.79 / $139.79	Professional	26	$139.79	$139.79	$139.79
United Facility/Professional Professional Modifier Low / Median / High Price $334.87 / $520.58 / $900.36	Professional		$334.87	$520.58	$900.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.36 / $97.55 / $180.91	Professional	26	$75.36	$97.55	$180.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $262.20 / $396.53 / $852.06	Professional	TC	$262.20	$396.53	$852.06