Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $281.84 / $354.81	Facility		$57.54	$281.84	$354.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $41.69 / $54.95	Facility	26	$33.11	$41.69	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $97.72 / $478.63	Professional		$51.29	$97.72	$478.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $48.98 / $194.98	Professional	26	$33.11	$48.98	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $34.67 / $169.82	Professional	TC	$25.12	$34.67	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $40.74 / $66.07	Professional		$30.20	$40.74	$66.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $120.23 / $151.36	Professional	26	$42.66	$120.23	$151.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $1,819.70 / $4,168.69	Facility		$676.08	$1,819.70	$4,168.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $177.83 / $263.03	Professional		$67.61	$177.83	$263.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $81.28 / $123.03	Professional	26	$38.02	$81.28	$123.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $93.33 / $173.78	Professional	TC	$28.84	$93.33	$173.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $83.18 / $213.80	Professional		$66.07	$83.18	$213.80
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $46.77 / $89.13	Professional	26	$38.90	$46.77	$89.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $35.48 / $125.89	Professional	TC	$28.18	$35.48	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $123.03 / $316.23	Professional		$67.61	$123.03	$316.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $70.79 / $138.04	Professional	26	$38.90	$70.79	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $52.48 / $194.98	Professional	TC	$28.84	$52.48	$194.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $104.71 / $870.96	Facility		$56.23	$104.71	$870.96
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $323.59 / $323.59	Facility	26	$134.90	$323.59	$323.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $147.91 / $1,318.26	Professional		$66.07	$147.91	$1,318.26
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $83.18 / $630.96	Professional	26	$38.90	$83.18	$630.96
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $64.57 / $870.96	Professional	TC	$27.54	$64.57	$870.96
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Professional		$52.48	$52.48	$52.48
United Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $630.96 / $1,380.38	Facility		$117.49	$630.96	$1,380.38
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $95.50 / $269.15	Professional		$61.66	$95.50	$269.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $53.70 / $112.20	Professional	26	$35.48	$53.70	$112.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $41.69 / $165.96	Professional	TC	$26.92	$41.69	$165.96