Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $45.71 / $64.57	Facility	26	$37.15	$45.71	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $229.09 / $562.34	Professional		$173.78	$229.09	$562.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $48.98 / $112.20	Professional	26	$30.90	$48.98	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $177.83 / $407.38	Professional	TC	$141.25	$177.83	$407.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $151.36 / $302.00	Professional		$144.54	$151.36	$302.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $42.66 / $66.07	Professional	26	$29.51	$42.66	$66.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $223.87 / $354.81	Professional		$181.97	$223.87	$354.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $42.66 / $63.10	Professional	26	$28.18	$42.66	$63.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $186.21 / $288.40	Professional	TC	$151.36	$186.21	$288.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $234.42 / $316.23	Professional		$194.98	$234.42	$316.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $42.66 / $57.54	Professional	26	$32.36	$42.66	$57.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $190.55 / $275.42	Professional	TC	$154.88	$190.55	$275.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $281.84 / $537.03	Professional		$181.97	$281.84	$537.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $44.67 / $89.13	Professional	26	$27.54	$44.67	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $245.47 / $457.09	Professional	TC	$151.36	$245.47	$457.09
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $169.82 / $169.82	Facility	26	$87.10	$169.82	$169.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $295.12 / $1,548.82	Professional		$190.55	$295.12	$1,548.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $54.95 / $389.05	Professional	26	$29.51	$54.95	$389.05
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $251.19 / $1,412.54	Professional	TC	$158.49	$251.19	$1,412.54
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $245.47 / $380.19	Professional		$190.55	$245.47	$380.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $40.74 / $70.79	Professional	26	$23.99	$40.74	$70.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $204.17 / $323.59	Professional	TC	$154.88	$204.17	$323.59