Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.93 / $42.62 / $71.31	Facility	26	$36.93	$42.62	$71.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.22 / $132.44 / $589.00	Professional		$60.22	$132.44	$589.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.61 / $42.46 / $100.10	Professional	26	$33.61	$42.46	$100.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.95 / $94.39 / $262.39	Professional	TC	$74.95	$94.39	$262.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.00 / $99.82 / $182.93	Professional		$89.00	$99.82	$182.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.32 / $39.88 / $55.32	Professional	26	$28.32	$39.88	$55.32
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $73.15 / $73.15 / $73.15	Professional	TC	$73.15	$73.15	$73.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.73 / $137.29 / $252.56	Professional		$112.73	$137.29	$252.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.31 / $47.27 / $81.80	Professional	26	$38.31	$47.27	$81.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.38 / $95.09 / $169.67	Professional	TC	$68.38	$95.09	$169.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.97 / $43.97 / $43.97	Facility	26	$43.97	$43.97	$43.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.00 / $169.98 / $272.02	Professional		$105.00	$169.98	$272.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.45 / $53.53 / $83.97	Professional	26	$33.45	$53.53	$83.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.15 / $118.46 / $190.19	Professional	TC	$73.15	$118.46	$190.19
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $90.38 / $172.60 / $172.60	Facility	26	$90.38	$172.60	$172.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $132.07 / $168.45 / $810.58	Professional		$132.07	$168.45	$810.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $41.39 / $51.05 / $242.65	Professional	26	$41.39	$51.05	$242.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $90.68 / $115.96 / $567.92	Professional	TC	$90.68	$115.96	$567.92
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $210.37 / $210.37 / $210.37	Professional		$210.37	$210.37	$210.37
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $63.62 / $63.62 / $63.62	Professional	26	$63.62	$63.62	$63.62
United Facility/Professional Professional Modifier Low / Median / High Price $132.07 / $154.03 / $252.65	Professional		$132.07	$154.03	$252.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.79 / $48.78 / $83.72	Professional	26	$40.79	$48.78	$83.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.10 / $104.65 / $176.60	Professional	TC	$85.10	$104.65	$176.60