Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $83.18 / $97.72	Facility	26	$83.18	$83.18	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $169.82 / $467.74	Professional		$138.04	$169.82	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $85.11 / $251.19	Professional	26	$72.44	$85.11	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $83.18 / $138.04	Professional	TC	$64.57	$83.18	$138.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $75.86 / $81.28	Professional	26	$74.13	$75.86	$81.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $257.04	Professional		$128.82	$169.82	$257.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $97.72 / $151.36	Professional	26	$77.62	$97.72	$151.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $72.44 / $128.82	Professional	TC	$30.90	$72.44	$128.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $194.98 / $263.03	Professional		$158.49	$194.98	$263.03
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $97.72 / $141.25	Professional	26	$83.18	$97.72	$141.25
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $95.50 / $128.82	Professional	TC	$75.86	$95.50	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $204.17 / $331.13	Professional		$138.04	$204.17	$331.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $112.20 / $173.78	Professional	26	$79.43	$112.20	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $97.72 / $162.18	Professional	TC	$46.77	$97.72	$162.18
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $354.81 / $354.81	Facility	26	$181.97	$354.81	$354.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $208.93 / $1,047.13	Professional		$138.04	$208.93	$1,047.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $117.49 / $512.86	Professional	26	$75.86	$117.49	$512.86
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $112.20 / $549.54	Professional	TC	$46.77	$112.20	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $186.21 / $316.23	Professional		$131.83	$186.21	$316.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $95.50 / $154.88	Professional	26	$72.44	$95.50	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $93.33 / $158.49	Professional	TC	$46.77	$93.33	$158.49