Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.22 / $157.61 / $240.10	Facility	26	$131.22	$157.61	$240.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $351.74 / $478.93 / $2,286.00	Professional		$351.74	$478.93	$2,286.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.61 / $180.14 / $582.97	Professional	26	$109.61	$180.14	$582.97
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $196.33 / $237.50 / $295.23	Professional	52	$196.33	$237.50	$295.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.98 / $335.00 / $1,426.48	Professional	TC	$269.98	$335.00	$1,426.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.35 / $231.70 / $280.27	Professional		$169.35	$231.70	$280.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.76 / $113.36 / $171.38	Professional	26	$80.76	$113.36	$171.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $179.88 / $179.88 / $179.88	Professional	TC	$179.88	$179.88	$179.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $337.02 / $442.50 / $1,292.94	Professional		$337.02	$442.50	$1,292.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $113.00 / $147.66 / $244.73	Professional	26	$113.00	$147.66	$244.73
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $224.03 / $297.52 / $1,048.24	Professional	TC	$224.03	$297.52	$1,048.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.88 / $123.88 / $123.88	Facility	26	$123.88	$123.88	$123.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $277.72 / $550.00 / $1,341.10	Professional		$277.72	$550.00	$1,341.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.10 / $156.51 / $268.81	Professional	26	$95.10	$156.51	$268.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $189.12 / $387.01 / $1,148.72	Professional	TC	$189.12	$387.01	$1,148.72
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $791.52 / $1,013.76 / $1,013.76	Facility	26	$791.52	$1,013.76	$1,013.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $362.16 / $811.38 / $6,146.58	Professional		$362.16	$811.38	$6,146.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $115.17 / $160.22 / $921.60	Professional	26	$115.17	$160.22	$921.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $245.74 / $628.46 / $5,551.18	Professional	TC	$245.74	$628.46	$5,551.18
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $197.09 / $197.09 / $197.09	Professional	26	$197.09	$197.09	$197.09
United Facility/Professional Professional Modifier Low / Median / High Price $352.11 / $532.40 / $1,280.21	Professional		$352.11	$532.40	$1,280.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $105.56 / $140.40 / $234.58	Professional	26	$105.56	$140.40	$234.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $233.72 / $341.95 / $910.69	Professional	TC	$233.72	$341.95	$910.69