Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.18 / $42.97 / $75.95	Facility	26	$29.18	$42.97	$75.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.83 / $107.06 / $400.00	Professional		$94.83	$107.06	$400.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.18 / $34.47 / $102.13	Professional	26	$29.18	$34.47	$102.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.30 / $74.53 / $146.62	Professional	TC	$65.30	$74.53	$146.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.19 / $77.19 / $178.51	Professional		$77.19	$77.19	$178.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.53 / $40.47 / $52.36	Professional	26	$24.53	$40.47	$52.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.33 / $120.95 / $223.00	Professional		$98.33	$120.95	$223.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.29 / $39.89 / $71.92	Professional	26	$34.29	$39.89	$71.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.04 / $79.55 / $149.74	Professional	TC	$64.04	$79.55	$149.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $37.82	Facility	26	$37.82	$37.82	$37.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.99 / $141.88 / $221.43	Professional		$88.99	$141.88	$221.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $47.38 / $72.88	Professional	26	$28.84	$47.38	$72.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.12 / $96.49 / $156.81	Professional	TC	$59.12	$96.49	$156.81
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $78.25 / $149.85 / $149.85	Facility	26	$78.25	$149.85	$149.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.48 / $133.13 / $730.62	Professional		$104.48	$133.13	$730.62
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $33.94 / $43.07 / $210.44	Professional	26	$33.94	$43.07	$210.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $69.88 / $89.64 / $520.19	Professional	TC	$69.88	$89.64	$520.19
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $60.21 / $60.21 / $60.21	Professional	26	$60.21	$60.21	$60.21
United Facility/Professional Professional Modifier Low / Median / High Price $95.00 / $119.47 / $207.76	Professional		$95.00	$119.47	$207.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.15 / $41.00 / $67.02	Professional	26	$32.15	$41.00	$67.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.56 / $83.73 / $144.62	Professional	TC	$69.56	$83.73	$144.62