Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.94 / $85.89 / $97.88	Facility	26	$78.94	$85.89	$97.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.08 / $160.87 / $342.21	Professional		$130.08	$160.87	$342.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.70 / $83.04 / $124.46	Professional	26	$74.70	$83.04	$124.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.03 / $78.06 / $106.57	Professional	TC	$55.03	$78.06	$106.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.48 / $76.48 / $93.07	Professional	26	$76.48	$76.48	$93.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.35 / $166.89 / $249.03	Professional		$117.35	$166.89	$249.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.97 / $98.00 / $149.49	Professional	26	$77.97	$98.00	$149.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.80 / $68.14 / $121.90	Professional	TC	$30.80	$68.14	$121.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.15 / $189.61 / $343.91	Professional		$113.15	$189.61	$343.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.33 / $112.75 / $178.56	Professional	26	$79.33	$112.75	$178.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.94 / $99.52 / $170.76	Professional	TC	$49.94	$99.52	$170.76
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $183.99 / $358.77 / $358.77	Facility	26	$183.99	$358.77	$358.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $132.34 / $229.70 / $1,053.48	Professional		$132.34	$229.70	$1,053.48
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $76.65 / $122.84 / $509.36	Professional	26	$76.65	$122.84	$509.36
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $46.61 / $122.50 / $544.05	Professional	TC	$46.61	$122.50	$544.05
United Facility/Professional Professional Modifier Low / Median / High Price $132.34 / $203.71 / $413.47	Professional		$132.34	$203.71	$413.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.40 / $99.20 / $180.69	Professional	26	$72.40	$99.20	$180.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.99 / $105.06 / $180.60	Professional	TC	$47.99	$105.06	$180.60