Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.04 / $42.52 / $73.15	Facility	26	$28.04	$42.52	$73.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.94 / $150.78 / $587.00	Professional		$114.94	$150.78	$587.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.04 / $36.39 / $165.00	Professional	26	$28.04	$36.39	$165.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $86.75 / $99.56 / $206.59	Professional	TC	$86.75	$99.56	$206.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.77 / $145.47 / $177.77	Professional		$130.77	$145.47	$177.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.53 / $34.68 / $45.84	Professional	26	$24.53	$34.68	$45.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.78 / $141.00 / $243.09	Professional		$105.78	$141.00	$243.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.04 / $40.54 / $67.03	Professional	26	$33.04	$40.54	$67.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.55 / $92.31 / $183.74	Professional	TC	$68.55	$92.31	$183.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.04 / $37.04 / $37.04	Facility	26	$37.04	$37.04	$37.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.88 / $176.10 / $391.24	Professional		$101.88	$176.10	$391.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.32 / $42.82 / $77.02	Professional	26	$28.32	$42.82	$77.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.75 / $143.71 / $303.49	Professional	TC	$65.75	$143.71	$303.49
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $76.68 / $147.81 / $147.81	Facility	26	$76.68	$147.81	$147.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $118.69 / $185.24 / $898.89	Professional		$118.69	$185.24	$898.89
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $33.04 / $41.84 / $371.50	Professional	26	$33.04	$41.84	$371.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $84.73 / $145.88 / $695.99	Professional	TC	$84.73	$145.88	$695.99
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $166.91 / $166.91 / $166.91	Professional		$166.91	$166.91	$166.91
United Facility/Professional Professional Modifier Low / Median / High Price $109.94 / $167.87 / $319.76	Professional		$109.94	$167.87	$319.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.43 / $37.72 / $62.84	Professional	26	$31.43	$37.72	$62.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.03 / $129.84 / $273.77	Professional	TC	$77.03	$129.84	$273.77