Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.34 / $77.54 / $127.52	Facility	26	$69.34	$77.54	$127.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.45 / $312.88 / $1,201.00	Professional		$250.45	$312.88	$1,201.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.24 / $76.50 / $285.68	Professional	26	$58.24	$76.50	$285.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.51 / $220.61 / $761.25	Professional	TC	$181.51	$220.61	$761.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $132.11 / $132.11 / $202.47	Professional		$132.11	$132.11	$202.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.49 / $62.62 / $94.95	Professional	26	$44.49	$62.62	$94.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $215.65 / $280.74 / $633.54	Professional		$215.65	$280.74	$633.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.89 / $80.56 / $133.03	Professional	26	$62.89	$80.56	$133.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $152.76 / $202.88 / $515.15	Professional	TC	$152.76	$202.88	$515.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.74 / $344.21 / $590.99	Professional		$195.74	$344.21	$590.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $86.12 / $150.50	Professional	26	$52.48	$86.12	$150.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.21 / $259.99 / $470.28	Professional	TC	$145.21	$259.99	$470.28
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $436.88 / $565.04 / $565.04	Facility	26	$436.88	$565.04	$565.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $249.48 / $374.21 / $1,846.75	Professional		$249.48	$374.21	$1,846.75
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $63.79 / $86.41 / $444.14	Professional	26	$63.79	$86.41	$444.14
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $183.75 / $291.01 / $2,104.00	Professional	TC	$183.75	$291.01	$2,104.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $109.19 / $109.19 / $109.19	Professional	26	$109.19	$109.19	$109.19
United Facility/Professional Professional Modifier Low / Median / High Price $235.39 / $325.87 / $548.96	Professional		$235.39	$325.87	$548.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.40 / $77.55 / $151.46	Professional	26	$61.40	$77.55	$151.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.73 / $237.12 / $400.04	Professional	TC	$169.73	$237.12	$400.04