Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $97.72 / $263.03	Facility	26	$64.57	$97.72	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $223.87 / $831.76	Professional		$138.04	$223.87	$831.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $85.11 / $223.87	Professional	26	$52.48	$85.11	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $114.82 / $346.74	Professional	TC	$77.62	$114.82	$346.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $60.26 / $91.20	Professional	26	$41.69	$60.26	$91.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $173.78 / $467.74	Professional		$138.04	$173.78	$467.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $74.13 / $117.49	Professional	26	$58.88	$74.13	$117.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $100.00 / $331.13	Professional	TC	$77.62	$100.00	$331.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $151.36 / $218.78	Professional		$144.54	$151.36	$218.78
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $66.07 / $93.33	Professional	26	$58.88	$66.07	$93.33
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $91.20 / $125.89	Professional	TC	$85.11	$91.20	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $218.78 / $426.58	Professional		$125.89	$218.78	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $77.62 / $147.91	Professional	26	$48.98	$77.62	$147.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $134.90 / $309.03	Professional	TC	$72.44	$134.90	$309.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $407.38 / $524.81 / $524.81	Facility	26	$407.38	$524.81	$524.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $269.15 / $1,548.82	Professional		$141.25	$269.15	$1,548.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $85.11 / $389.05	Professional	26	$53.70	$85.11	$389.05
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $181.97 / $1,659.59	Professional	TC	$81.28	$181.97	$1,659.59
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $102.33 / $102.33	Professional	26	$102.33	$102.33	$102.33
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $138.04 / $138.04	Professional	TC	$138.04	$138.04	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $194.98 / $346.74	Professional		$134.90	$194.98	$346.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $67.61 / $114.82	Professional	26	$52.48	$67.61	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $112.20 / $245.47	Professional	TC	$77.62	$112.20	$245.47