Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.83 / $34.14 / $60.07	Facility	26	$27.83	$34.14	$60.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.15 / $97.42 / $447.89	Professional		$83.15	$97.42	$447.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.12 / $29.54 / $102.93	Professional	26	$21.12	$29.54	$102.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.94 / $69.95 / $144.69	Professional	TC	$58.94	$69.95	$144.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.35 / $71.50 / $83.10	Professional		$54.35	$71.50	$83.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.10 / $35.61 / $42.60	Professional	26	$21.10	$35.61	$42.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.45 / $107.37 / $168.70	Professional		$88.45	$107.37	$168.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.31 / $35.79 / $48.35	Professional	26	$28.31	$35.79	$48.35
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.10 / $69.79 / $120.90	Professional	TC	$55.10	$69.79	$120.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.53 / $116.15 / $194.57	Professional		$72.53	$116.15	$194.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.92 / $33.70 / $62.54	Professional	26	$20.92	$33.70	$62.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.71 / $85.61 / $141.31	Professional	TC	$50.71	$85.61	$141.31
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $67.28 / $128.65 / $128.65	Facility	26	$67.28	$128.65	$128.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.13 / $117.36 / $648.50	Professional		$83.13	$117.36	$648.50
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $24.33 / $39.09 / $180.32	Professional	26	$24.33	$39.09	$180.32
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $57.05 / $83.77 / $468.12	Professional	TC	$57.05	$83.77	$468.12
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $51.78 / $51.78 / $51.78	Professional	26	$51.78	$51.78	$51.78
United Facility/Professional Professional Modifier Low / Median / High Price $83.13 / $104.49 / $184.81	Professional		$83.13	$104.49	$184.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.60 / $33.52 / $58.19	Professional	26	$23.60	$33.52	$58.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.62 / $74.08 / $124.32	Professional	TC	$56.62	$74.08	$124.32