Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $281.84 / $812.83	Facility		$109.65	$281.84	$812.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $33.88 / $61.66	Facility	26	$25.70	$33.88	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $112.20 / $245.47	Professional		$56.23	$112.20	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $36.31 / $67.61	Professional	26	$21.88	$36.31	$67.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $83.18 / $144.54	Professional	TC	$52.48	$83.18	$144.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $81.28 / $102.33	Professional		$69.18	$81.28	$102.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $27.54 / $38.90	Professional	26	$19.50	$27.54	$38.90
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $75.86 / $75.86	Professional	TC	$75.86	$75.86	$75.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $112.20 / $194.98	Professional		$91.20	$112.20	$194.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $34.67 / $52.48	Professional	26	$27.54	$34.67	$52.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $72.44 / $144.54	Professional	TC	$64.57	$72.44	$144.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $97.72 / $234.42	Facility		$70.79	$97.72	$234.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $131.83 / $208.93	Professional		$123.03	$131.83	$208.93
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $30.20 / $47.86	Professional	26	$29.51	$30.20	$47.86
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $102.33 / $151.36	Professional	TC	$91.20	$102.33	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $114.82 / $204.17	Professional		$79.43	$114.82	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $32.36 / $58.88	Professional	26	$22.39	$32.36	$58.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $83.18 / $154.88	Professional	TC	$58.88	$83.18	$154.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $151.36 / $275.42	Facility		$95.50	$151.36	$275.42
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $134.90 / $134.90	Facility	26	$61.66	$134.90	$134.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $109.65 / $758.58	Professional		$77.62	$109.65	$758.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $31.62 / $169.82	Professional	26	$25.12	$31.62	$169.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $81.28 / $588.84	Professional	TC	$50.12	$81.28	$588.84
United Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $58.88 / $77.62	Facility		$17.78	$58.88	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $107.15 / $173.78	Professional		$75.86	$107.15	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $28.84 / $43.65	Professional	26	$25.12	$28.84	$43.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $77.62 / $125.89	Professional	TC	$48.98	$77.62	$125.89