Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.42 / $71.79 / $119.79	Facility	26	$62.42	$71.79	$119.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.35 / $249.83 / $809.64	Professional		$148.35	$249.83	$809.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.42 / $69.58 / $243.00	Professional	26	$54.42	$69.58	$243.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.16 / $147.81 / $523.41	Professional	TC	$88.16	$147.81	$523.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.22 / $78.22 / $99.62	Professional		$78.22	$78.22	$99.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.57 / $68.25 / $88.73	Professional	26	$41.57	$68.25	$88.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.50 / $177.54 / $492.80	Professional		$137.50	$177.54	$492.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.08 / $75.43 / $123.45	Professional	26	$59.08	$75.43	$123.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.42 / $104.14 / $336.09	Professional	TC	$78.42	$104.14	$336.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.44 / $64.44 / $64.44	Facility	26	$64.44	$64.44	$64.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.24 / $225.00 / $448.42	Professional		$119.24	$225.00	$448.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.08 / $80.23 / $141.38	Professional	26	$49.08	$80.23	$141.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.38 / $138.07 / $319.47	Professional	TC	$72.38	$138.07	$319.47
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $407.44 / $527.60 / $527.60	Facility	26	$407.44	$527.60	$527.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $151.58 / $275.30 / $1,561.56	Professional		$151.58	$275.30	$1,561.56
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $59.46 / $82.12 / $386.35	Professional	26	$59.46	$82.12	$386.35
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $90.19 / $186.18 / $1,649.00	Professional	TC	$90.19	$186.18	$1,649.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $102.04 / $102.04 / $102.04	Professional	26	$102.04	$102.04	$102.04
United Facility/Professional Professional Modifier Low / Median / High Price $147.22 / $208.51 / $349.87	Professional		$147.22	$208.51	$349.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.66 / $70.47 / $132.63	Professional	26	$54.66	$70.47	$132.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.13 / $122.29 / $235.72	Professional	TC	$87.13	$122.29	$235.72