Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.18 / $59.90 / $125.43	Professional		$48.18	$59.90	$125.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.05 / $32.31 / $59.34	Professional	26	$28.05	$32.31	$59.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.88 / $23.50 / $36.77	Professional	TC	$19.88	$23.50	$36.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.72 / $60.72 / $60.72	Professional		$60.72	$60.72	$60.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.78 / $46.78 / $46.78	Professional	26	$46.78	$46.78	$46.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.99 / $64.00 / $107.47	Professional		$53.99	$64.00	$107.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.74 / $43.24 / $67.39	Professional	26	$32.74	$43.24	$67.39
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.00 / $24.39 / $36.50	Professional	TC	$16.00	$24.39	$36.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.22 / $70.76 / $121.79	Professional		$52.22	$70.76	$121.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.32 / $42.79 / $78.87	Professional	26	$31.32	$42.79	$78.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.69 / $28.22 / $46.45	Professional	TC	$20.69	$28.22	$46.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $84.68 / $84.68 / $165.02	Facility	26	$84.68	$84.68	$165.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.61 / $66.95 / $396.08	Professional		$43.61	$66.95	$396.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $27.46 / $40.46 / $347.34	Professional	26	$27.46	$40.46	$347.34
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $16.89 / $26.50 / $166.53	Professional	TC	$16.89	$26.50	$166.53
United Facility/Professional Professional Modifier Low / Median / High Price $45.22 / $63.33 / $108.98	Professional		$45.22	$63.33	$108.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.78 / $38.18 / $71.12	Professional	26	$26.78	$38.18	$71.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.89 / $25.93 / $41.83	Professional	TC	$16.89	$25.93	$41.83