Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $93.33 / $194.98	Facility	26	$58.88	$93.33	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $151.36 / $707.95	Professional		$102.33	$151.36	$707.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $173.78 / $851.14	Professional	26	$57.54	$173.78	$851.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $70.79 / $380.19	Professional	TC	$52.48	$70.79	$380.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $138.04 / $190.55	Professional		$93.33	$138.04	$190.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $63.10 / $87.10	Professional	26	$44.67	$63.10	$87.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $47.86 / $47.86	Professional	TC	$47.86	$47.86	$47.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $162.18 / $288.40	Professional		$120.23	$162.18	$288.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $79.43 / $123.03	Professional	26	$58.88	$79.43	$123.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $87.10 / $181.97	Professional	TC	$60.26	$87.10	$181.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $154.88 / $218.78	Professional		$131.83	$154.88	$218.78
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $74.13 / $104.71	Professional	26	$64.57	$74.13	$104.71
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $81.28 / $112.20	Professional	TC	$66.07	$81.28	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $190.55 / $269.15	Professional		$112.20	$190.55	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $85.11 / $123.03	Professional	26	$57.54	$85.11	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $100.00 / $158.49	Professional	TC	$63.10	$100.00	$158.49
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $346.74 / $346.74	Facility	26	$141.25	$346.74	$346.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $181.97 / $1,047.13	Professional		$109.65	$181.97	$1,047.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $74.13 / $851.14	Professional	26	$54.95	$74.13	$851.14
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $97.72 / $724.44	Professional	TC	$57.54	$97.72	$724.44
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $154.88 / $251.19	Professional		$117.49	$154.88	$251.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $70.79 / $114.82	Professional	26	$57.54	$70.79	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $89.13 / $138.04	Professional	TC	$58.88	$89.13	$138.04