Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.98 / $281.39 / $876.14	Facility		$50.98	$281.39	$876.14
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.21 / $37.97 / $65.02	Facility	26	$29.21	$37.97	$65.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.71 / $109.87 / $559.29	Professional		$50.71	$109.87	$559.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.56 / $32.29 / $135.18	Professional	26	$26.56	$32.29	$135.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.14 / $31.59 / $240.37	Professional	TC	$24.14	$31.59	$240.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.16 / $75.06 / $93.47	Professional		$42.16	$75.06	$93.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.45 / $32.27 / $45.19	Professional	26	$22.45	$32.27	$45.19
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.07 / $40.07 / $42.05	Professional	TC	$40.07	$40.07	$42.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.57 / $70.05 / $272.39	Professional		$53.57	$70.05	$272.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.75 / $39.07 / $65.88	Professional	26	$31.75	$39.07	$65.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.82 / $29.39 / $231.49	Professional	TC	$21.82	$29.39	$231.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.84 / $65.84 / $65.84	Facility		$65.84	$65.84	$65.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.51 / $34.51 / $34.51	Facility	26	$34.51	$34.51	$34.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.39 / $90.71 / $290.44	Professional		$48.39	$90.71	$290.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.38 / $41.04 / $74.54	Professional	26	$26.38	$41.04	$74.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.71 / $41.85 / $229.10	Professional	TC	$20.71	$41.85	$229.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $52.39 / $91.52 / $359.27	Facility		$52.39	$91.52	$359.27
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $72.14 / $261.98 / $261.98	Facility	26	$72.14	$261.98	$261.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.47 / $139.71 / $947.00	Professional		$58.47	$139.71	$947.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.96 / $39.74 / $368.00	Professional	26	$30.96	$39.74	$368.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.99 / $70.17 / $758.00	Professional	TC	$25.99	$70.17	$758.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $55.19 / $55.19 / $55.19	Professional	26	$55.19	$55.19	$55.19
United Facility/Professional Professional Modifier Low / Median / High Price $54.50 / $76.01 / $186.15	Professional		$54.50	$76.01	$186.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.23 / $35.72 / $58.94	Professional	26	$29.23	$35.72	$58.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.17 / $31.81 / $159.33	Professional	TC	$24.17	$31.81	$159.33