Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.04 / $39.54 / $65.08	Facility	26	$25.04	$39.54	$65.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.57 / $106.50 / $221.58	Professional		$90.57	$106.50	$221.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.03 / $29.39 / $87.43	Professional	26	$25.03	$29.39	$87.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.54 / $73.55 / $148.65	Professional	TC	$65.54	$73.55	$148.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.02 / $70.75 / $113.39	Professional		$60.02	$70.75	$113.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.08 / $31.70 / $46.73	Professional	26	$21.08	$31.70	$46.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.70 / $117.81 / $195.53	Professional		$97.70	$117.81	$195.53
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.54 / $34.22 / $55.97	Professional	26	$29.54	$34.22	$55.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.16 / $83.29 / $139.54	Professional	TC	$68.16	$83.29	$139.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $32.36 / $32.36	Facility	26	$32.36	$32.36	$32.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.31 / $130.13 / $228.02	Professional		$83.31	$130.13	$228.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.74 / $37.46 / $69.28	Professional	26	$24.74	$37.46	$69.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.37 / $93.01 / $165.50	Professional	TC	$61.37	$93.01	$165.50
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $67.03 / $128.65 / $128.65	Facility	26	$67.03	$128.65	$128.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $98.74 / $123.52 / $674.54	Professional		$98.74	$123.52	$674.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $27.37 / $35.34 / $180.38	Professional	26	$27.37	$35.34	$180.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $71.45 / $87.33 / $494.15	Professional	TC	$71.45	$87.33	$494.15
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $51.69 / $51.69 / $51.69	Professional	26	$51.69	$51.69	$51.69
United Facility/Professional Professional Modifier Low / Median / High Price $95.81 / $120.68 / $219.34	Professional		$95.81	$120.68	$219.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.29 / $34.93 / $66.31	Professional	26	$27.29	$34.93	$66.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.48 / $83.19 / $140.66	Professional	TC	$67.48	$83.19	$140.66