Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.95 / $105.79 / $175.51	Facility	26	$91.95	$105.79	$175.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.95 / $390.81 / $1,449.44	Professional		$269.95	$390.81	$1,449.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.58 / $95.53 / $384.82	Professional	26	$76.58	$95.53	$384.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $182.47 / $270.97 / $1,053.10	Professional	TC	$182.47	$270.97	$1,053.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $195.36 / $209.03 / $244.84	Professional		$195.36	$209.03	$244.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.31 / $86.06 / $123.29	Professional	26	$61.31	$86.06	$123.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $260.82 / $344.76 / $770.29	Professional		$260.82	$344.76	$770.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $86.55 / $111.35 / $182.98	Professional	26	$86.55	$111.35	$182.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $174.26 / $237.37 / $607.42	Professional	TC	$174.26	$237.37	$607.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.56 / $94.56 / $94.56	Facility	26	$94.56	$94.56	$94.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.60 / $450.00 / $974.13	Professional		$239.60	$450.00	$974.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.22 / $118.43 / $206.84	Professional	26	$72.22	$118.43	$206.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $171.76 / $344.87 / $832.72	Professional	TC	$171.76	$344.87	$832.72
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $600.40 / $773.84 / $773.84	Facility	26	$600.40	$773.84	$773.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $301.35 / $552.54 / $3,234.12	Professional		$301.35	$552.54	$3,234.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.41 / $118.74 / $559.72	Professional	26	$87.41	$118.74	$559.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $210.32 / $425.68 / $2,749.60	Professional	TC	$210.32	$425.68	$2,749.60
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $150.16 / $150.16 / $150.16	Professional	26	$150.16	$150.16	$150.16
United Facility/Professional Professional Modifier Low / Median / High Price $291.67 / $432.13 / $779.90	Professional		$291.67	$432.13	$779.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.96 / $104.38 / $193.14	Professional	26	$83.96	$104.38	$193.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $206.74 / $315.57 / $584.94	Professional	TC	$206.74	$315.57	$584.94