Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.81 / $30.80 / $53.68	Facility	26	$25.81	$30.80	$53.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.04 / $57.97 / $232.00	Professional		$46.04	$57.97	$232.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.69 / $43.49 / $93.51	Professional	26	$25.69	$43.49	$93.51
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $36.34 / $57.49 / $285.00	Professional	52	$36.34	$57.49	$285.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.69 / $25.33 / $142.41	Professional	TC	$20.69	$25.33	$142.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.97 / $44.61 / $76.17	Professional		$37.97	$44.61	$76.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.10 / $31.76 / $41.24	Professional	26	$21.10	$31.76	$41.24
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.25 / $20.01 / $34.94	Professional	TC	$17.25	$20.01	$34.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $62.37 / $107.73	Professional		$51.31	$62.37	$107.73
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.54 / $34.99 / $62.24	Professional	26	$29.54	$34.99	$62.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.77 / $26.99 / $45.35	Professional	TC	$21.77	$26.99	$45.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.34 / $71.78 / $114.10	Professional		$44.34	$71.78	$114.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.76 / $41.05 / $63.26	Professional	26	$24.76	$41.05	$63.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.93 / $32.04 / $50.83	Professional	TC	$19.93	$32.04	$50.83
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $67.28 / $128.65 / $128.65	Facility	26	$67.28	$128.65	$128.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.52 / $70.20 / $334.42	Professional		$54.52	$70.20	$334.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.38 / $39.40 / $182.49	Professional	26	$30.38	$39.40	$182.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.23 / $31.35 / $151.88	Professional	TC	$24.23	$31.35	$151.88
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $87.60 / $87.60 / $87.60	Professional		$87.60	$87.60	$87.60
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $46.68 / $47.43 / $47.43	Professional	26	$46.68	$47.43	$47.43
United Facility/Professional Professional Modifier Low / Median / High Price $54.56 / $67.13 / $106.77	Professional		$54.56	$67.13	$106.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.21 / $36.70 / $61.36	Professional	26	$30.21	$36.70	$61.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.19 / $28.93 / $47.99	Professional	TC	$24.19	$28.93	$47.99