Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $109.65 / $181.97	Facility	26	$102.33	$109.65	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $245.47 / $724.44	Professional		$165.96	$245.47	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $125.89 / $426.58	Professional	26	$95.50	$125.89	$426.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $79.43 / $154.88	Professional	TC	$67.61	$79.43	$154.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $190.55 / $269.15	Professional		$147.91	$190.55	$269.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $123.03 / $141.25	Professional	26	$93.33	$123.03	$141.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $190.55 / $295.12	Professional		$162.18	$190.55	$295.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $109.65 / $169.82	Professional	26	$91.20	$109.65	$169.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $79.43 / $128.82	Professional	TC	$67.61	$79.43	$128.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $218.78 / $309.03	Professional		$181.97	$218.78	$309.03
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $128.82 / $181.97	Professional	26	$109.65	$128.82	$181.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $91.20 / $128.82	Professional	TC	$75.86	$91.20	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $257.04 / $389.05	Professional		$186.21	$257.04	$389.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $147.91 / $229.09	Professional	26	$104.71	$147.91	$229.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $104.71 / $162.18	Professional	TC	$72.44	$104.71	$162.18
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $239.88 / $467.74 / $467.74	Facility	26	$239.88	$467.74	$467.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $245.47 / $1,148.15	Professional		$173.78	$245.47	$1,148.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $144.54 / $660.69	Professional	26	$100.00	$144.54	$660.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $107.15 / $478.63	Professional	TC	$74.13	$107.15	$478.63
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $234.42	Professional		$218.78	$218.78	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $213.80 / $363.08	Professional		$165.96	$213.80	$363.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $125.89 / $204.17	Professional	26	$97.72	$125.89	$204.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $93.33 / $151.36	Professional	TC	$72.44	$93.33	$151.36