Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $128.82 / $331.13	Facility	26	$79.43	$128.82	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $173.78 / $602.56	Professional		$123.03	$173.78	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $89.13 / $223.87	Professional	26	$56.23	$89.13	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $93.33 / $263.03	Professional	TC	$64.57	$93.33	$263.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $95.50	Professional		$91.20	$91.20	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $67.61 / $100.00	Professional	26	$51.29	$67.61	$100.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $173.78 / $512.86	Professional		$141.25	$173.78	$512.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $83.18 / $131.83	Professional	26	$69.18	$83.18	$131.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $87.10 / $457.09	Professional	TC	$67.61	$87.10	$457.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $134.90 / $177.83	Professional		$128.82	$134.90	$177.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $75.86 / $97.72	Professional	26	$72.44	$75.86	$97.72
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $60.26 / $91.20	Professional	TC	$57.54	$60.26	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $204.17 / $407.38	Professional		$120.23	$204.17	$407.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $81.28 / $147.91	Professional	26	$52.48	$81.28	$147.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $104.71 / $275.42	Professional	TC	$57.54	$104.71	$275.42
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $501.19 / $645.65 / $645.65	Facility	26	$501.19	$645.65	$645.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $229.09 / $1,412.54	Professional		$131.83	$229.09	$1,412.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $87.10 / $436.52	Professional	26	$57.54	$87.10	$436.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $114.82 / $1,148.15	Professional	TC	$66.07	$114.82	$1,148.15
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $125.89 / $125.89	Professional	26	$125.89	$125.89	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $173.78 / $338.84	Professional		$131.83	$173.78	$338.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $77.62 / $141.25	Professional	26	$56.23	$77.62	$141.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $91.20 / $213.80	Professional	TC	$66.07	$91.20	$213.80