Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $61.66 / $97.72	Facility	26	$40.74	$61.66	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $144.54 / $549.54	Professional		$107.15	$144.54	$549.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $57.54 / $131.83	Professional	26	$33.88	$57.54	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $95.50 / $218.78	Professional	TC	$74.13	$95.50	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $141.25 / $208.93	Professional		$97.72	$141.25	$208.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $45.71 / $61.66	Professional	26	$26.92	$45.71	$61.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $147.91 / $239.88	Professional		$123.03	$147.91	$239.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $43.65 / $74.13	Professional	26	$33.88	$43.65	$74.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $100.00 / $158.49	Professional	TC	$83.18	$100.00	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $147.91 / $186.21	Professional		$141.25	$147.91	$186.21
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $46.77 / $60.26	Professional	26	$44.67	$46.77	$60.26
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $100.00 / $128.82	Professional	TC	$95.50	$100.00	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $162.18 / $316.23	Professional		$104.71	$162.18	$316.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $48.98 / $93.33	Professional	26	$31.62	$48.98	$93.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $117.49 / $229.09	Professional	TC	$74.13	$117.49	$229.09
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $190.55 / $190.55	Facility	26	$100.00	$190.55	$190.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $169.82 / $933.25	Professional		$114.82	$169.82	$933.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $57.54 / $269.15	Professional	26	$35.48	$57.54	$269.15
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $123.03 / $660.69	Professional	TC	$77.62	$123.03	$660.69
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Professional	26	$77.62	$77.62	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $144.54 / $239.88	Professional		$109.65	$144.54	$239.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $45.71 / $79.43	Professional	26	$34.67	$45.71	$79.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $100.00 / $173.78	Professional	TC	$75.86	$100.00	$173.78