Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.09 / $110.72 / $179.63	Facility	26	$96.09	$110.72	$179.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $374.41 / $1,567.56	Professional		$275.00	$374.41	$1,567.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.70 / $99.01 / $354.05	Professional	26	$81.70	$99.01	$354.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $182.47 / $291.01 / $1,053.10	Professional	TC	$182.47	$291.01	$1,053.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.38 / $213.55 / $445.46	Professional		$162.38	$213.55	$445.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.73 / $89.92 / $128.81	Professional	26	$63.73	$89.92	$128.81
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $319.42 / $319.42 / $319.42	Professional	TC	$319.42	$319.42	$319.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $264.27 / $351.27 / $785.64	Professional		$264.27	$351.27	$785.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $90.01 / $107.87 / $192.58	Professional	26	$90.01	$107.87	$192.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $174.26 / $240.12 / $607.07	Professional	TC	$174.26	$240.12	$607.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.41 / $98.41 / $98.41	Facility	26	$98.41	$98.41	$98.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $244.48 / $448.45 / $858.00	Professional		$244.48	$448.45	$858.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.59 / $122.74 / $218.83	Professional	26	$75.59	$122.74	$218.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $174.41 / $330.26 / $676.05	Professional	TC	$174.41	$330.26	$676.05
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $627.76 / $804.96 / $804.96	Facility	26	$627.76	$804.96	$804.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $307.83 / $528.14 / $3,183.14	Professional		$307.83	$528.14	$3,183.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $93.11 / $123.60 / $1,009.00	Professional	26	$93.11	$123.60	$1,009.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $213.95 / $407.74 / $2,699.58	Professional	TC	$213.95	$407.74	$2,699.58
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $156.43 / $156.43 / $156.43	Professional	26	$156.43	$156.43	$156.43
United Facility/Professional Professional Modifier Low / Median / High Price $298.01 / $441.07 / $811.73	Professional		$298.01	$441.07	$811.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.46 / $110.56 / $186.22	Professional	26	$88.46	$110.56	$186.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.77 / $319.19 / $550.69	Professional	TC	$208.77	$319.19	$550.69