Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.42 / $101.50 / $188.22	Facility	26	$94.42	$101.50	$188.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.54 / $289.87 / $817.45	Professional		$245.54	$289.87	$817.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.73 / $94.42 / $276.38	Professional	26	$76.73	$94.42	$276.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $152.69 / $212.28 / $455.79	Professional	TC	$152.69	$212.28	$455.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.80 / $85.37 / $129.80	Professional	26	$60.80	$85.37	$129.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $243.04 / $313.95 / $557.71	Professional		$243.04	$313.95	$557.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.88 / $102.15 / $178.17	Professional	26	$85.88	$102.15	$178.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $157.16 / $204.91 / $399.16	Professional	TC	$157.16	$204.91	$399.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.84 / $93.84 / $93.84	Facility	26	$93.84	$93.84	$93.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.03 / $334.08 / $556.47	Professional		$204.03	$334.08	$556.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.31 / $116.19 / $204.53	Professional	26	$71.31	$116.19	$204.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $129.37 / $220.51 / $391.20	Professional	TC	$129.37	$220.51	$391.20
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $595.28 / $768.32 / $768.32	Facility	26	$595.28	$768.32	$768.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $252.99 / $352.39 / $1,515.48	Professional		$252.99	$352.39	$1,515.48
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.44 / $106.87 / $521.79	Professional	26	$87.44	$106.87	$521.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $163.72 / $238.08 / $993.68	Professional	TC	$163.72	$238.08	$993.68
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $149.27 / $149.27 / $149.27	Professional	26	$149.27	$149.27	$149.27
United Facility/Professional Professional Modifier Low / Median / High Price $246.92 / $317.12 / $538.67	Professional		$246.92	$317.12	$538.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.90 / $103.61 / $190.91	Professional	26	$79.90	$103.61	$190.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.31 / $229.89 / $367.91	Professional	TC	$159.31	$229.89	$367.91