Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.35 / $56.19 / $86.98	Facility	26	$45.35	$56.19	$86.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.34 / $174.81 / $625.00	Professional		$104.34	$174.81	$625.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.58 / $72.56 / $241.61	Professional	26	$41.58	$72.56	$241.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.97 / $78.84 / $235.66	Professional	TC	$58.97	$78.84	$235.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.34 / $93.54 / $193.53	Professional		$81.34	$93.54	$193.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.85 / $52.24 / $70.13	Professional	26	$34.85	$52.24	$70.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $53.46 / $96.23 / $113.25	Professional	TC	$53.46	$96.23	$113.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.83 / $138.28 / $230.07	Professional		$112.83	$138.28	$230.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.33 / $60.69 / $93.22	Professional	26	$49.33	$60.69	$93.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.49 / $78.23 / $139.75	Professional	TC	$63.49	$78.23	$139.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.62 / $53.62 / $53.62	Facility	26	$53.62	$53.62	$53.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.04 / $147.19 / $257.06	Professional		$97.04	$147.19	$257.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.38 / $63.17 / $115.64	Professional	26	$40.38	$63.17	$115.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.54 / $88.32 / $154.61	Professional	TC	$54.54	$88.32	$154.61
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $111.13 / $211.96 / $211.96	Facility	26	$111.13	$211.96	$211.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $119.35 / $149.94 / $757.96	Professional		$119.35	$149.94	$757.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $47.33 / $60.49 / $312.14	Professional	26	$47.33	$60.49	$312.14
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $71.26 / $89.18 / $470.82	Professional	TC	$71.26	$89.18	$470.82
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $85.53 / $85.53 / $85.53	Professional	26	$85.53	$85.53	$85.53
United Facility/Professional Professional Modifier Low / Median / High Price $112.06 / $135.99 / $225.11	Professional		$112.06	$135.99	$225.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.61 / $55.98 / $103.21	Professional	26	$45.61	$55.98	$103.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.70 / $80.98 / $133.43	Professional	TC	$67.70	$80.98	$133.43