Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.54 / $103.79 / $296.83	Facility		$35.54	$103.79	$296.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.03 / $43.56 / $67.51	Facility	26	$29.03	$43.56	$67.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.70 / $82.40 / $190.19	Professional		$41.70	$82.40	$190.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.46 / $45.34 / $136.74	Professional	26	$26.46	$45.34	$136.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $70.08 / $179.00 / $352.20	Professional	50	$70.08	$179.00	$352.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.23 / $19.05 / $86.06	Professional	TC	$15.23	$19.05	$86.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.01 / $29.01 / $29.01	Professional	26	$29.01	$29.01	$29.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.66 / $77.02 / $160.76	Professional		$56.66	$77.02	$160.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.60 / $45.86 / $90.47	Professional	26	$33.60	$45.86	$90.47
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $84.99 / $115.44 / $241.14	Professional	50	$84.99	$115.44	$241.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.06 / $29.21 / $82.41	Professional	TC	$23.06	$29.21	$82.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.79 / $100.86 / $455.25	Facility		$53.79	$100.86	$455.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.29 / $34.29 / $34.29	Facility	26	$34.29	$34.29	$34.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.44 / $87.65 / $166.60	Professional		$42.44	$87.65	$166.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.83 / $48.42 / $93.63	Professional	26	$26.83	$48.42	$93.63
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $79.23 / $79.23 / $79.23	Professional	50	$79.23	$79.23	$79.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.45 / $36.68 / $96.09	Professional	TC	$15.45	$36.68	$96.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.36 / $83.40 / $261.86	Facility		$42.36	$83.40	$261.86
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.02 / $198.78 / $198.78	Facility	26	$70.02	$198.78	$198.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.77 / $95.96 / $659.45	Professional		$53.77	$95.96	$659.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.11 / $51.54 / $335.18	Professional	26	$32.11	$51.54	$335.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.56 / $40.25 / $404.98	Professional	TC	$21.56	$40.25	$404.98
United Facility/Professional Facility Modifier Low / Median / High Price $114.42 / $136.18 / $250.18	Facility		$114.42	$136.18	$250.18
United Facility/Professional Professional Modifier Low / Median / High Price $53.07 / $76.66 / $127.20	Professional		$53.07	$76.66	$127.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.01 / $44.27 / $67.02	Professional	26	$31.01	$44.27	$67.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.89 / $27.63 / $51.77	Professional	TC	$19.89	$27.63	$51.77