Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.89 / $48.10 / $75.59	Facility	26	$38.89	$48.10	$75.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.75 / $162.22 / $576.00	Professional		$93.75	$162.22	$576.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.40 / $62.76 / $223.00	Professional	26	$35.40	$62.76	$223.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.28 / $70.04 / $186.23	Professional	TC	$57.28	$70.04	$186.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.43 / $86.75 / $136.94	Professional		$75.43	$86.75	$136.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.84 / $44.76 / $64.03	Professional	26	$29.84	$44.76	$64.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $52.44 / $94.39 / $110.51	Professional	TC	$52.44	$94.39	$110.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.03 / $127.50 / $206.33	Professional		$105.03	$127.50	$206.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.09 / $50.56 / $80.20	Professional	26	$43.09	$50.56	$80.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.94 / $75.16 / $120.81	Professional	TC	$61.94	$75.16	$120.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.25 / $46.25 / $46.25	Facility	26	$46.25	$46.25	$46.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.47 / $133.74 / $240.11	Professional		$82.47	$133.74	$240.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.65 / $53.52 / $98.63	Professional	26	$34.65	$53.52	$98.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.11 / $81.56 / $150.97	Professional	TC	$51.11	$81.56	$150.97
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $95.69 / $181.68 / $181.68	Facility	26	$95.69	$181.68	$181.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $103.62 / $138.51 / $708.49	Professional		$103.62	$138.51	$708.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.77 / $53.72 / $257.68	Professional	26	$40.77	$53.72	$257.68
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $62.73 / $85.58 / $450.80	Professional	TC	$62.73	$85.58	$450.80
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $69.09 / $69.09 / $73.63	Professional	26	$69.09	$69.09	$73.63
United Facility/Professional Professional Modifier Low / Median / High Price $100.62 / $122.94 / $230.26	Professional		$100.62	$122.94	$230.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.97 / $48.66 / $81.70	Professional	26	$38.97	$48.66	$81.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.47 / $75.43 / $130.32	Professional	TC	$60.47	$75.43	$130.32