Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $29.51 / $35.48	Facility	26	$23.99	$29.51	$35.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $151.36 / $380.19	Professional		$114.82	$151.36	$380.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $28.84 / $81.28	Professional	26	$20.89	$28.84	$81.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $112.20 / $281.84	Professional	TC	$91.20	$112.20	$281.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $95.50 / $190.55	Professional		$91.20	$95.50	$190.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $24.55 / $38.90	Professional	26	$17.38	$24.55	$38.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $169.82 / $251.19	Professional		$123.03	$169.82	$251.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $28.84 / $43.65	Professional	26	$22.91	$28.84	$43.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $141.25 / $208.93	Professional	TC	$97.72	$141.25	$208.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $144.54 / $190.55	Professional		$120.23	$144.54	$190.55
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $27.54 / $37.15	Professional	26	$23.99	$27.54	$37.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $117.49 / $154.88	Professional	TC	$97.72	$117.49	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $181.97 / $338.84	Professional		$117.49	$181.97	$338.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $30.90 / $61.66	Professional	26	$21.88	$30.90	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $154.88 / $295.12	Professional	TC	$97.72	$154.88	$295.12
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $173.78 / $173.78	Facility	26	$53.70	$173.78	$173.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $190.55 / $1,047.13	Professional		$123.03	$190.55	$1,047.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $34.67 / $302.00	Professional	26	$21.88	$34.67	$302.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $158.49 / $912.01	Professional	TC	$97.72	$158.49	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $158.49 / $251.19	Professional		$120.23	$158.49	$251.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $27.54 / $45.71	Professional	26	$20.42	$27.54	$45.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $125.89 / $204.17	Professional	TC	$95.50	$125.89	$204.17