Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.67 / $56.55 / $87.54	Facility	26	$45.67	$56.55	$87.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.31 / $196.03 / $639.00	Professional		$118.31	$196.03	$639.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.57 / $66.81 / $196.67	Professional	26	$41.57	$66.81	$196.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.73 / $96.51 / $233.71	Professional	TC	$76.73	$96.51	$233.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.15 / $115.02 / $187.49	Professional		$93.15	$115.02	$187.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.07 / $52.60 / $80.26	Professional	26	$35.07	$52.60	$80.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $66.79 / $120.20 / $126.15	Professional	TC	$66.79	$120.20	$126.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.74 / $160.04 / $255.69	Professional		$128.74	$160.04	$255.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.69 / $61.69 / $97.55	Professional	26	$49.69	$61.69	$97.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.05 / $98.94 / $165.85	Professional	TC	$79.05	$98.94	$165.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.96 / $53.96 / $53.96	Facility	26	$53.96	$53.96	$53.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.73 / $169.88 / $295.55	Professional		$107.73	$169.88	$295.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.24 / $64.00 / $116.27	Professional	26	$40.24	$64.00	$116.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.51 / $109.56 / $192.37	Professional	TC	$70.51	$109.56	$192.37
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $111.76 / $213.45 / $213.45	Facility	26	$111.76	$213.45	$213.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $135.41 / $171.39 / $872.98	Professional		$135.41	$171.39	$872.98
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $47.33 / $61.97 / $298.50	Professional	26	$47.33	$61.97	$298.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $87.82 / $109.99 / $574.48	Professional	TC	$87.82	$109.99	$574.48
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $230.08 / $230.08 / $230.08	Professional		$230.08	$230.08	$230.08
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $75.42 / $86.08 / $92.30	Professional	26	$75.42	$86.08	$92.30
United Facility/Professional Professional Modifier Low / Median / High Price $128.30 / $154.78 / $257.93	Professional		$128.30	$154.78	$257.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.21 / $55.98 / $94.78	Professional	26	$45.21	$55.98	$94.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.49 / $96.24 / $163.15	Professional	TC	$82.49	$96.24	$163.15