Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.89 / $129.53 / $284.88	Professional		$87.89	$129.53	$284.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.65 / $76.89 / $191.06	Professional	26	$64.65	$76.89	$191.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.24 / $26.28 / $91.57	Professional	TC	$23.24	$26.28	$91.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $191.35 / $191.35 / $191.35	Professional		$191.35	$191.35	$191.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.04 / $40.04 / $40.04	Professional	26	$40.04	$40.04	$40.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.87 / $147.00 / $282.68	Professional		$54.87	$147.00	$282.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.58 / $121.21 / $174.04	Professional	26	$36.58	$121.21	$174.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.33 / $34.19 / $96.73	Professional	TC	$22.33	$34.19	$96.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.92 / $81.56 / $291.48	Professional		$55.92	$81.56	$291.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.93 / $84.08 / $182.88	Professional	26	$40.93	$84.08	$182.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.77 / $26.67 / $113.98	Professional	TC	$12.77	$26.67	$113.98
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $390.55 / $390.55 / $390.55	Facility	26	$390.55	$390.55	$390.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.59 / $150.80 / $745.14	Professional		$70.59	$150.80	$745.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $54.57 / $120.58 / $538.00	Professional	26	$54.57	$120.58	$538.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $16.02 / $49.70 / $340.13	Professional	TC	$16.02	$49.70	$340.13
United Facility/Professional Professional Modifier Low / Median / High Price $67.58 / $122.63 / $230.42	Professional		$67.58	$122.63	$230.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.45 / $89.46 / $178.97	Professional	26	$52.45	$89.46	$178.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.02 / $26.70 / $62.08	Professional	TC	$16.02	$26.70	$62.08