Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $104.71 / $123.03	Facility	26	$104.71	$104.71	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $281.84 / $457.09	Professional		$234.42	$281.84	$457.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $104.71 / $165.96	Professional	26	$89.13	$104.71	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $181.97 / $323.59	Professional	TC	$141.25	$181.97	$323.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $123.03 / $123.03	Professional	26	$123.03	$123.03	$123.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $281.84 / $478.63	Professional		$204.17	$281.84	$478.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $120.23 / $177.83	Professional	26	$93.33	$120.23	$177.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $177.83 / $295.12	Professional	TC	$102.33	$177.83	$295.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $380.19 / $537.03	Professional		$302.00	$380.19	$537.03
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $123.03 / $177.83	Professional	26	$104.71	$123.03	$177.83
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $251.19 / $371.54	Professional	TC	$199.53	$251.19	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $380.19 / $630.96	Professional		$251.19	$380.19	$630.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $141.25 / $218.78	Professional	26	$100.00	$141.25	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $234.42 / $426.58	Professional	TC	$154.88	$234.42	$426.58
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $234.42 / $446.68 / $446.68	Facility	26	$234.42	$446.68	$446.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $363.08 / $1,995.26	Professional		$234.42	$363.08	$1,995.26
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $147.91 / $724.44	Professional	26	$95.50	$147.91	$724.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $223.87 / $1,584.89	Professional	TC	$131.83	$223.87	$1,584.89
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $141.25 / $141.25	Professional	26	$141.25	$141.25	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $316.23 / $512.86	Professional		$208.93	$316.23	$512.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $120.23 / $194.98	Professional	26	$91.20	$120.23	$194.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $190.55 / $323.59	Professional	TC	$123.03	$190.55	$323.59