Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.73 / $128.09 / $238.06	Facility	26	$103.73	$128.09	$238.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.50 / $179.81 / $750.93	Professional		$114.50	$179.81	$750.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.92 / $114.87 / $368.29	Professional	26	$90.92	$114.87	$368.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.29 / $42.02 / $279.72	Professional	TC	$26.29	$42.02	$279.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $164.86 / $164.86 / $225.74	Professional		$164.86	$164.86	$225.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $82.18 / $120.01 / $166.59	Professional	26	$82.18	$120.01	$166.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.12 / $186.18 / $508.65	Professional		$127.12	$186.18	$508.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.68 / $131.78 / $210.04	Professional	26	$104.68	$131.78	$210.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.44 / $48.81 / $298.61	Professional	TC	$22.44	$48.81	$298.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.25 / $215.58 / $541.10	Professional		$133.25	$215.58	$541.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.80 / $149.15 / $230.34	Professional	26	$100.80	$149.15	$230.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.96 / $50.56 / $411.57	Professional	TC	$30.96	$50.56	$411.57
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $250.54 / $722.52 / $722.52	Facility	26	$250.54	$722.52	$722.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $136.78 / $206.93 / $3,014.42	Professional		$136.78	$206.93	$3,014.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $106.28 / $134.13 / $1,056.82	Professional	26	$106.28	$134.13	$1,056.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.17 / $49.36 / $2,488.46	Professional	TC	$26.17	$49.36	$2,488.46
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $259.60 / $259.60 / $259.60	Professional		$259.60	$259.60	$259.60
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $195.29 / $195.29 / $195.29	Professional	26	$195.29	$195.29	$195.29
United Facility/Professional Professional Modifier Low / Median / High Price $133.94 / $188.53 / $438.13	Professional		$133.94	$188.53	$438.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $105.26 / $132.72 / $235.01	Professional	26	$105.26	$132.72	$235.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.17 / $38.65 / $161.82	Professional	TC	$26.17	$38.65	$161.82