Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.72 / $45.13 / $56.59	Facility	26	$37.72	$45.13	$56.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.44 / $237.90 / $750.00	Professional		$170.44	$237.90	$750.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.30 / $43.17 / $93.86	Professional	26	$28.30	$43.17	$93.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.24 / $169.96 / $451.72	Professional	TC	$141.24	$169.96	$451.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $106.56 / $139.16 / $214.60	Professional		$106.56	$139.16	$214.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.64 / $38.28 / $56.19	Professional	26	$27.64	$38.28	$56.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $189.44 / $232.90 / $360.69	Professional		$189.44	$232.90	$360.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.61 / $44.48 / $65.28	Professional	26	$35.61	$44.48	$65.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $149.32 / $188.46 / $285.11	Professional	TC	$149.32	$188.46	$285.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.27 / $43.27 / $43.27	Facility	26	$43.27	$43.27	$43.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.05 / $282.68 / $509.49	Professional		$182.05	$282.68	$509.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.40 / $48.53 / $88.61	Professional	26	$35.40	$48.53	$88.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.18 / $235.79 / $423.48	Professional	TC	$145.18	$235.79	$423.48
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $87.82 / $210.00 / $210.00	Facility	26	$87.82	$210.00	$210.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $203.55 / $291.51 / $1,582.03	Professional		$203.55	$291.51	$1,582.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.67 / $56.70 / $422.69	Professional	26	$30.67	$56.70	$422.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $162.77 / $234.75 / $1,414.75	Professional	TC	$162.77	$234.75	$1,414.75
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $246.79 / $246.79 / $246.79	Professional		$246.79	$246.79	$246.79
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $52.97 / $52.97 / $64.62	Professional	26	$52.97	$52.97	$64.62
United Facility/Professional Professional Modifier Low / Median / High Price $197.96 / $249.43 / $411.17	Professional		$197.96	$249.43	$411.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.59 / $48.94 / $88.16	Professional	26	$30.59	$48.94	$88.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $157.55 / $206.04 / $384.97	Professional	TC	$157.55	$206.04	$384.97