Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $129.00 / $141.68 / $231.26	Facility	26	$129.00	$141.68	$231.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $417.27 / $510.17 / $2,746.55	Professional		$417.27	$510.17	$2,746.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $125.78 / $162.13 / $571.86	Professional	26	$125.78	$162.13	$571.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $299.00 / $361.94 / $1,088.34	Professional	TC	$299.00	$361.94	$1,088.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.75 / $194.75 / $255.98	Professional		$194.75	$194.75	$255.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.37 / $100.87 / $152.37	Professional	26	$75.37	$100.87	$152.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $358.68 / $540.13 / $1,268.06	Professional		$358.68	$540.13	$1,268.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $105.73 / $123.88 / $222.80	Professional	26	$105.73	$123.88	$222.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $252.95 / $407.02 / $1,045.26	Professional	TC	$252.95	$407.02	$1,045.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.17 / $116.17 / $116.17	Facility	26	$116.17	$116.17	$116.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $294.91 / $575.00 / $1,372.97	Professional		$294.91	$575.00	$1,372.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.60 / $144.55 / $249.54	Professional	26	$88.60	$144.55	$249.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $212.85 / $429.28 / $1,205.06	Professional	TC	$212.85	$429.28	$1,205.06
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $742.64 / $950.80 / $950.80	Facility	26	$742.64	$950.80	$950.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $389.72 / $805.24 / $5,981.06	Professional		$389.72	$805.24	$5,981.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $105.21 / $149.40 / $883.52	Professional	26	$105.21	$149.40	$883.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $281.05 / $643.41 / $5,438.76	Professional	TC	$281.05	$643.41	$5,438.76
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $184.98 / $184.98 / $184.98	Professional	26	$184.98	$184.98	$184.98
United Facility/Professional Professional Modifier Low / Median / High Price $382.20 / $558.04 / $1,433.98	Professional		$382.20	$558.04	$1,433.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $98.64 / $127.87 / $220.75	Professional	26	$98.64	$127.87	$220.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $274.48 / $406.10 / $974.10	Professional	TC	$274.48	$406.10	$974.10