Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.73 / $38.97 / $63.80	Facility	26	$31.73	$38.97	$63.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.12 / $138.41 / $635.70	Professional		$92.12	$138.41	$635.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.89 / $45.30 / $135.55	Professional	26	$28.89	$45.30	$135.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.24 / $92.96 / $431.00	Professional	TC	$63.24	$92.96	$431.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.31 / $83.33 / $146.26	Professional		$70.31	$83.33	$146.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.17 / $31.44 / $51.51	Professional	26	$24.17	$31.44	$51.51
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $47.21 / $99.94 / $117.11	Professional	TC	$47.21	$99.94	$117.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.75 / $123.73 / $210.47	Professional		$99.75	$123.73	$210.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.07 / $42.06 / $67.03	Professional	26	$34.07	$42.06	$67.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $65.67 / $82.53 / $146.97	Professional	TC	$65.67	$82.53	$146.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.07 / $37.07 / $37.07	Facility	26	$37.07	$37.07	$37.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.31 / $131.47 / $232.56	Professional		$84.31	$131.47	$232.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.60 / $42.57 / $79.94	Professional	26	$27.60	$42.57	$79.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.70 / $87.84 / $160.41	Professional	TC	$57.70	$87.84	$160.41
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $77.02 / $171.00 / $171.00	Facility	26	$77.02	$171.00	$171.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $103.53 / $136.91 / $687.27	Professional		$103.53	$136.91	$687.27
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.96 / $43.28 / $254.27	Professional	26	$32.96	$43.28	$254.27
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $69.73 / $93.99 / $479.00	Professional	TC	$69.73	$93.99	$479.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $178.89 / $178.89 / $178.89	Professional		$178.89	$178.89	$178.89
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $55.90 / $55.90 / $59.24	Professional	26	$55.90	$55.90	$59.24
United Facility/Professional Professional Modifier Low / Median / High Price $100.10 / $120.54 / $220.45	Professional		$100.10	$120.54	$220.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.51 / $38.51 / $74.41	Professional	26	$31.51	$38.51	$74.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.44 / $84.16 / $139.09	Professional	TC	$64.44	$84.16	$139.09