Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.28 / $107.22 / $173.97	Facility	26	$78.28	$107.22	$173.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.99 / $230.66 / $906.00	Professional		$194.99	$230.66	$906.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.31 / $95.14 / $293.83	Professional	26	$76.31	$95.14	$293.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $106.42 / $136.56 / $564.00	Professional	TC	$106.42	$136.56	$564.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.81 / $134.34 / $148.72	Professional		$105.81	$134.34	$148.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.05 / $76.31 / $122.79	Professional	26	$61.05	$76.31	$122.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $87.32 / $87.32 / $172.08	Professional	TC	$87.32	$87.32	$172.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $184.83 / $238.91 / $438.40	Professional		$184.83	$238.91	$438.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $86.19 / $112.44 / $174.13	Professional	26	$86.19	$112.44	$174.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $98.64 / $129.96 / $264.25	Professional	TC	$98.64	$129.96	$264.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.15 / $94.15 / $94.15	Facility	26	$94.15	$94.15	$94.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.77 / $270.47 / $429.14	Professional		$165.77	$270.47	$429.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.56 / $117.94 / $205.98	Professional	26	$71.56	$117.94	$205.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.29 / $156.12 / $261.00	Professional	TC	$91.29	$156.12	$261.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $598.00 / $770.72 / $770.72	Facility	26	$598.00	$770.72	$770.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $198.70 / $268.04 / $1,217.23	Professional		$198.70	$268.04	$1,217.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $88.62 / $108.71 / $521.24	Professional	26	$88.62	$108.71	$521.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $110.39 / $152.74 / $1,308.00	Professional	TC	$110.39	$152.74	$1,308.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $149.51 / $149.51 / $149.51	Professional	26	$149.51	$149.51	$149.51
United Facility/Professional Professional Modifier Low / Median / High Price $197.51 / $243.82 / $414.94	Professional		$197.51	$243.82	$414.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.04 / $105.86 / $193.50	Professional	26	$84.04	$105.86	$193.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $107.30 / $141.19 / $232.02	Professional	TC	$107.30	$141.19	$232.02