Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.54 / $86.18 / $145.43	Facility	26	$69.54	$86.18	$145.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.63 / $171.80 / $867.26	Professional		$130.63	$171.80	$867.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.19 / $86.19 / $213.33	Professional	26	$55.19	$86.19	$213.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.68 / $86.40 / $425.50	Professional	TC	$69.68	$86.40	$425.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $211.40	Professional		$95.50	$95.50	$211.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.53 / $77.26 / $103.35	Professional	26	$53.53	$77.26	$103.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.68 / $171.17 / $397.55	Professional		$140.68	$171.17	$397.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.95 / $84.61 / $121.22	Professional	26	$69.95	$84.61	$121.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.54 / $87.29 / $276.33	Professional	TC	$67.54	$87.29	$276.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.31 / $79.31 / $79.31	Facility	26	$79.31	$79.31	$79.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.55 / $202.23 / $410.91	Professional		$115.55	$202.23	$410.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.80 / $82.24 / $139.31	Professional	26	$51.80	$82.24	$139.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.49 / $104.29 / $332.33	Professional	TC	$56.49	$104.29	$332.33
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $503.20 / $646.64 / $646.64	Facility	26	$503.20	$646.64	$646.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $149.74 / $230.67 / $1,406.40	Professional		$149.74	$230.67	$1,406.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $60.34 / $90.05 / $439.49	Professional	26	$60.34	$90.05	$439.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $75.12 / $116.92 / $1,140.03	Professional	TC	$75.12	$116.92	$1,140.03
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $125.76 / $125.76 / $125.76	Professional	26	$125.76	$125.76	$125.76
United Facility/Professional Professional Modifier Low / Median / High Price $138.37 / $179.78 / $395.36	Professional		$138.37	$179.78	$395.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.86 / $83.37 / $164.20	Professional	26	$60.86	$83.37	$164.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.76 / $93.76 / $203.80	Professional	TC	$74.76	$93.76	$203.80