Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.74 / $51.36 / $68.31	Facility	26	$37.74	$51.36	$68.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.21 / $103.70 / $347.97	Professional		$47.21	$103.70	$347.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $41.46 / $105.44	Professional	26	$24.78	$41.46	$105.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.48 / $19.73 / $221.08	Professional	TC	$9.48	$19.73	$221.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.66 / $40.52 / $46.32	Professional		$30.66	$40.52	$46.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.47 / $44.55 / $67.89	Professional	26	$41.47	$44.55	$67.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.36 / $100.12 / $206.94	Professional		$81.36	$100.12	$206.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.24 / $38.20 / $59.49	Professional	26	$31.24	$38.20	$59.49
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $122.04 / $150.18 / $310.41	Professional	50	$122.04	$150.18	$310.41
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.40 / $62.98 / $153.99	Professional	TC	$37.40	$62.98	$153.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.32 / $49.32 / $49.32	Facility	26	$49.32	$49.32	$49.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.45 / $115.56 / $201.00	Professional		$50.45	$115.56	$201.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.52 / $43.01 / $76.88	Professional	26	$28.52	$43.01	$76.88
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $115.21 / $115.21 / $115.21	Professional	50	$115.21	$115.21	$115.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.47 / $70.40 / $141.25	Professional	TC	$9.47	$70.40	$141.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $101.38 / $193.75 / $193.75	Facility	26	$101.38	$193.75	$193.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.09 / $117.15 / $558.63	Professional		$75.09	$117.15	$558.63
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.87 / $37.45 / $260.82	Professional	26	$29.87	$37.45	$260.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $41.95 / $81.80 / $430.88	Professional	TC	$41.95	$81.80	$430.88
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $78.06 / $78.06 / $78.06	Professional	26	$78.06	$78.06	$78.06
United Facility/Professional Professional Modifier Low / Median / High Price $71.37 / $103.87 / $153.68	Professional		$71.37	$103.87	$153.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.91 / $37.64 / $86.60	Professional	26	$28.91	$37.64	$86.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.07 / $55.80 / $104.98	Professional	TC	$20.07	$55.80	$104.98