Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.75 / $65.27 / $119.35	Facility	26	$54.75	$65.27	$119.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $246.93 / $307.13 / $1,098.00	Professional		$246.93	$307.13	$1,098.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.75 / $87.48 / $351.10	Professional	26	$54.75	$87.48	$351.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $217.43 / $462.46	Professional	TC	$162.34	$217.43	$462.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $184.79 / $193.97 / $298.60	Professional		$184.79	$193.97	$298.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.04 / $54.67 / $81.27	Professional	26	$40.04	$54.67	$81.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $225.03 / $332.56 / $481.92	Professional		$225.03	$332.56	$481.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.96 / $103.02 / $157.04	Professional	26	$59.96	$103.02	$157.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $160.63 / $222.79 / $327.91	Professional	TC	$160.63	$222.79	$327.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.58 / $62.58 / $62.58	Facility	26	$62.58	$62.58	$62.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $253.33 / $411.42 / $732.57	Professional		$253.33	$411.42	$732.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.61 / $97.11 / $184.75	Professional	26	$54.61	$97.11	$184.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $200.02 / $323.33 / $582.45	Professional	TC	$200.02	$323.33	$582.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $127.27 / $377.88 / $377.88	Facility	26	$127.27	$377.88	$377.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $282.58 / $406.08 / $2,362.07	Professional		$282.58	$406.08	$2,362.07
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $58.83 / $93.27 / $507.12	Professional	26	$58.83	$93.27	$507.12
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $223.75 / $320.97 / $1,854.93	Professional	TC	$223.75	$320.97	$1,854.93
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $343.39 / $343.39 / $343.39	Professional		$343.39	$343.39	$343.39
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $76.73 / $76.73 / $76.73	Professional	26	$76.73	$76.73	$76.73
United Facility/Professional Professional Modifier Low / Median / High Price $281.38 / $359.42 / $598.65	Professional		$281.38	$359.42	$598.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.29 / $78.68 / $140.19	Professional	26	$58.29	$78.68	$140.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.56 / $275.39 / $473.18	Professional	TC	$218.56	$275.39	$473.18