Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $36.31 / $69.18	Facility	26	$32.36	$36.31	$69.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $154.88 / $346.74	Professional		$95.50	$154.88	$346.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $45.71 / $131.83	Professional	26	$33.11	$45.71	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $83.18 / $218.78	Professional	TC	$56.23	$83.18	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $147.91 / $234.42	Professional		$104.71	$147.91	$234.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Professional	26	$74.13	$74.13	$74.13
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $154.88 / $154.88 / $154.88	Professional	50	$154.88	$154.88	$154.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $134.90 / $218.78	Professional		$100.00	$134.90	$218.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $52.48 / $79.43	Professional	26	$42.66	$52.48	$79.43
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $151.36 / $204.17 / $331.13	Professional	50	$151.36	$204.17	$331.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $83.18 / $144.54	Professional	TC	$54.95	$83.18	$144.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $186.21 / $239.88	Professional		$147.91	$186.21	$239.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $53.70 / $69.18	Professional	26	$42.66	$53.70	$69.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $134.90 / $181.97	Professional	TC	$83.18	$134.90	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $169.82 / $309.03	Professional		$109.65	$169.82	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $60.26 / $104.71	Professional	26	$40.74	$60.26	$104.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $109.65 / $204.17	Professional	TC	$64.57	$109.65	$204.17
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $213.80 / $213.80	Facility	26	$95.50	$213.80	$213.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $144.54 / $831.76	Professional		$91.20	$144.54	$831.76
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $54.95 / $263.03	Professional	26	$38.02	$54.95	$263.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $87.10 / $602.56	Professional	TC	$52.48	$87.10	$602.56
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $114.82 / $186.21	Professional		$87.10	$114.82	$186.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $44.67 / $66.07	Professional	26	$35.48	$44.67	$66.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $67.61 / $120.23	Professional	TC	$46.77	$67.61	$120.23