Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.88 / $41.69 / $81.28	Facility	26	$33.88	$41.69	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $114.82 / $436.52	Professional		$67.61	$114.82	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $54.95 / $162.18	Professional	26	$28.84	$54.95	$162.18
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $67.61 / $323.59 / $812.83	Professional	50	$67.61	$323.59	$812.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $70.79 / $154.88	Professional	TC	$52.48	$70.79	$154.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $75.86 / $169.82	Professional		$72.44	$75.86	$169.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $48.98 / $81.28	Professional	26	$25.70	$48.98	$81.28
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $109.65 / $117.49 / $251.19	Professional	50	$109.65	$117.49	$251.19
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $60.26 / $60.26	Professional	TC	$60.26	$60.26	$60.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $117.49 / $194.98	Professional		$97.72	$117.49	$194.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $41.69 / $67.61	Professional	26	$36.31	$41.69	$67.61
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $177.83 / $288.40	Professional	50	$147.91	$177.83	$288.40
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $75.86 / $125.89	Professional	TC	$61.66	$75.86	$125.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $112.20 / $162.18	Professional		$102.33	$112.20	$162.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $39.81 / $57.54	Professional	26	$36.31	$39.81	$57.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $72.44 / $102.33	Professional	TC	$66.07	$72.44	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $131.83 / $263.03	Professional		$85.11	$131.83	$263.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $46.77 / $91.20	Professional	26	$30.20	$46.77	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $87.10 / $173.78	Professional	TC	$57.54	$87.10	$173.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $158.49 / $158.49	Facility	26	$81.28	$158.49	$158.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $125.89 / $660.69	Professional		$93.33	$125.89	$660.69
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $43.65 / $218.78	Professional	26	$32.36	$43.65	$218.78
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $81.28 / $446.68	Professional	TC	$61.66	$81.28	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $114.82 / $186.21	Professional		$93.33	$114.82	$186.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $39.81 / $63.10	Professional	26	$33.11	$39.81	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $74.13 / $120.23	Professional	TC	$61.66	$74.13	$120.23