Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $95.50 / $123.03	Facility	26	$81.28	$95.50	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $251.19 / $1,047.13	Professional		$173.78	$251.19	$1,047.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $102.33 / $346.74	Professional	26	$64.57	$102.33	$346.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $141.25 / $346.74	Professional	TC	$102.33	$141.25	$346.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $158.49 / $426.58	Professional		$151.36	$158.49	$426.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $77.62 / $117.49	Professional	26	$63.10	$77.62	$117.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $239.88 / $416.87	Professional		$181.97	$239.88	$416.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $87.10 / $151.36	Professional	26	$69.18	$87.10	$151.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $154.88 / $239.88	Professional	TC	$107.15	$154.88	$239.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $223.87 / $302.00	Professional		$181.97	$223.87	$302.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $83.18 / $109.65	Professional	26	$70.79	$83.18	$109.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $138.04 / $204.17	Professional	TC	$114.82	$138.04	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $269.15 / $489.78	Professional		$169.82	$269.15	$489.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $100.00 / $194.98	Professional	26	$70.79	$100.00	$194.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $173.78 / $316.23	Professional	TC	$107.15	$173.78	$316.23
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $562.34 / $562.34	Facility	26	$162.18	$562.34	$562.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $309.03 / $1,659.59	Professional		$177.83	$309.03	$1,659.59
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $120.23 / $724.44	Professional	26	$70.79	$120.23	$724.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $194.98 / $977.24	Professional	TC	$109.65	$194.98	$977.24
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $239.88 / $398.11	Professional		$177.83	$239.88	$398.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $93.33 / $147.91	Professional	26	$67.61	$93.33	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $144.54 / $257.04	Professional	TC	$109.65	$144.54	$257.04