Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $660.69 / $1,318.26	Facility		$316.23	$660.69	$1,318.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $257.04 / $851.14	Professional		$70.79	$257.04	$851.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $162.18 / $812.83	Professional	26	$25.70	$162.18	$812.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $64.57 / $275.42	Professional	TC	$40.74	$64.57	$275.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $56.23 / $120.23	Professional		$40.74	$56.23	$120.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $25.70 / $35.48	Professional	26	$12.59	$25.70	$35.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $60.26 / $64.57	Professional	TC	$30.20	$60.26	$64.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $87.10 / $138.04	Professional		$64.57	$87.10	$138.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $29.51 / $50.12	Professional	26	$21.38	$29.51	$50.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $54.95 / $93.33	Professional	TC	$43.65	$54.95	$93.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $87.10 / $151.36	Professional		$75.86	$87.10	$151.36
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $27.54 / $44.67	Professional	26	$25.12	$27.54	$44.67
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $61.66 / $107.15	Professional	TC	$51.29	$61.66	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $47.86 / $177.83	Professional		$32.36	$47.86	$177.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $15.14 / $60.26	Professional	26	$10.96	$15.14	$60.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.88 / $123.03	Professional	TC	$21.88	$33.88	$123.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $85.11 / $229.09	Facility		$69.18	$85.11	$229.09
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $123.03 / $123.03	Facility	26	$123.03	$123.03	$123.03
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $316.23 / $316.23 / $316.23	Facility	TC	$316.23	$316.23	$316.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $93.33 / $562.34	Professional		$56.23	$93.33	$562.34
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $33.11 / $173.78	Professional	26	$17.78	$33.11	$173.78
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $69.18 / $389.05	Professional	TC	$38.90	$69.18	$389.05
United Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $33.11 / $46.77	Facility		$13.18	$33.11	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $91.20 / $169.82	Professional		$51.29	$91.20	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $29.51 / $54.95	Professional	26	$16.60	$29.51	$54.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $61.66 / $114.82	Professional	TC	$34.67	$61.66	$114.82