Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.32 / $84.65 / $139.91	Facility	26	$25.32	$84.65	$139.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $256.92 / $366.58 / $1,321.00	Professional		$256.92	$366.58	$1,321.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.09 / $81.59 / $310.57	Professional	26	$64.09	$81.59	$310.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.49 / $253.82 / $1,025.66	Professional	TC	$181.49	$253.82	$1,025.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $181.56 / $195.19 / $195.53	Professional		$181.56	$195.19	$195.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.85 / $68.56 / $104.15	Professional	26	$48.85	$68.56	$104.15
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $152.90 / $152.90 / $152.90	Professional	TC	$152.90	$152.90	$152.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $243.40 / $316.39 / $740.00	Professional		$243.40	$316.39	$740.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $88.78 / $145.50	Professional	26	$69.18	$88.78	$145.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $174.22 / $227.18 / $588.16	Professional	TC	$174.22	$227.18	$588.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.64 / $75.64 / $75.64	Facility	26	$75.64	$75.64	$75.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.04 / $409.55 / $744.30	Professional		$220.04	$409.55	$744.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.77 / $94.96 / $165.58	Professional	26	$57.77	$94.96	$165.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $166.12 / $317.24 / $607.82	Professional	TC	$166.12	$317.24	$607.82
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $478.24 / $619.20 / $619.20	Facility	26	$478.24	$619.20	$619.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $283.30 / $451.73 / $2,385.40	Professional		$283.30	$451.73	$2,385.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $69.69 / $95.00 / $533.30	Professional	26	$69.69	$95.00	$533.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $209.34 / $370.03 / $2,603.00	Professional	TC	$209.34	$370.03	$2,603.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $119.77 / $119.77 / $119.77	Professional	26	$119.77	$119.77	$119.77
United Facility/Professional Professional Modifier Low / Median / High Price $254.97 / $377.90 / $622.34	Professional		$254.97	$377.90	$622.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.77 / $83.75 / $153.47	Professional	26	$66.77	$83.75	$153.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $193.48 / $296.07 / $495.34	Professional	TC	$193.48	$296.07	$495.34