Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.37 / $118.26 / $192.68	Facility	26	$107.37	$118.26	$192.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $344.36 / $475.00 / $1,742.69	Professional		$344.36	$475.00	$1,742.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.09 / $139.55 / $443.06	Professional	26	$105.09	$139.55	$443.06
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $166.49 / $212.50 / $250.59	Professional	52	$166.49	$212.50	$250.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $227.87 / $314.75 / $1,020.25	Professional	TC	$227.87	$314.75	$1,020.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $155.35 / $155.35 / $155.35	Professional		$155.35	$155.35	$155.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.91 / $93.79 / $133.21	Professional	26	$64.91	$93.79	$133.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $284.91 / $373.40 / $1,014.91	Professional		$284.91	$373.40	$1,014.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.26 / $113.35 / $185.21	Professional	26	$88.26	$113.35	$185.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $196.66 / $261.18 / $829.72	Professional	TC	$196.66	$261.18	$829.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.46 / $96.46 / $96.46	Facility	26	$96.46	$96.46	$96.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.50 / $453.78 / $963.81	Professional		$235.50	$453.78	$963.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.68 / $121.25 / $208.68	Professional	26	$73.68	$121.25	$208.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $167.10 / $333.48 / $815.12	Professional	TC	$167.10	$333.48	$815.12
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $612.55 / $789.76 / $789.76	Facility	26	$612.55	$789.76	$789.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $308.49 / $629.95 / $3,445.62	Professional		$308.49	$629.95	$3,445.62
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.09 / $124.73 / $672.00	Professional	26	$87.09	$124.73	$672.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $215.63 / $487.19 / $2,996.90	Professional	TC	$215.63	$487.19	$2,996.90
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $153.19 / $153.19 / $153.19	Professional	26	$153.19	$153.19	$153.19
United Facility/Professional Professional Modifier Low / Median / High Price $303.49 / $439.07 / $957.13	Professional		$303.49	$439.07	$957.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.18 / $104.74 / $182.62	Professional	26	$82.18	$104.74	$182.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $200.08 / $311.23 / $686.63	Professional	TC	$200.08	$311.23	$686.63