Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.43 / $263.00 / $751.16	Facility		$99.43	$263.00	$751.16
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.64 / $31.53 / $49.39	Facility	26	$9.64	$31.53	$49.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.87 / $127.97 / $527.00	Professional		$96.87	$127.97	$527.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.86 / $37.40 / $105.95	Professional	26	$23.86	$37.40	$105.95
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $46.89 / $52.85 / $63.64	Professional	52	$46.89	$52.85	$63.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.01 / $94.28 / $262.08	Professional	TC	$73.01	$94.28	$262.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.79 / $86.37 / $133.75	Professional		$77.79	$86.37	$133.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.82 / $24.89 / $42.31	Professional	26	$19.82	$24.89	$42.31
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $53.94 / $68.98 / $136.88	Professional	TC	$53.94	$68.98	$136.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $327.00 / $327.00 / $355.00	Facility		$327.00	$327.00	$355.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.03 / $128.85 / $209.36	Professional		$104.03	$128.85	$209.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.79 / $34.29 / $55.15	Professional	26	$27.79	$34.29	$55.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.34 / $94.55 / $157.80	Professional	TC	$73.34	$94.55	$157.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $136.69 / $256.54 / $455.25	Facility		$136.69	$256.54	$455.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.47 / $30.47 / $30.47	Facility	26	$30.47	$30.47	$30.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $132.72 / $245.40	Professional		$81.90	$132.72	$245.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.94 / $35.68 / $64.73	Professional	26	$22.94	$35.68	$64.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.79 / $101.34 / $185.84	Professional	TC	$63.79	$101.34	$185.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $98.44 / $147.72 / $358.77	Facility		$98.44	$147.72	$358.77
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $63.16 / $122.00 / $122.00	Facility	26	$63.16	$122.00	$122.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $101.71 / $137.87 / $726.73	Professional		$101.71	$137.87	$726.73
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.85 / $34.69 / $255.92	Professional	26	$26.85	$34.69	$255.92
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $77.09 / $105.57 / $554.94	Professional	TC	$77.09	$105.57	$554.94
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $185.47 / $185.47 / $185.47	Professional		$185.47	$185.47	$185.47
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $48.66 / $48.66 / $48.66	Professional	26	$48.66	$48.66	$48.66
United Facility/Professional Facility Modifier Low / Median / High Price $80.87 / $136.18 / $245.18	Facility		$80.87	$136.18	$245.18
United Facility/Professional Professional Modifier Low / Median / High Price $99.34 / $123.91 / $210.35	Professional		$99.34	$123.91	$210.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.89 / $31.54 / $52.25	Professional	26	$25.89	$31.54	$52.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.45 / $92.84 / $157.38	Professional	TC	$73.45	$92.84	$157.38