Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $150.28 / $154.97 / $247.27	Facility	26	$150.28	$154.97	$247.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $395.33 / $482.27 / $2,133.98	Professional		$395.33	$482.27	$2,133.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $126.00 / $177.46 / $591.23	Professional	26	$126.00	$177.46	$591.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $270.86 / $335.00 / $1,020.25	Professional	TC	$270.86	$335.00	$1,020.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $352.82 / $352.82 / $352.82	Professional		$352.82	$352.82	$352.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $82.96 / $121.48 / $162.88	Professional	26	$82.96	$121.48	$162.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $181.00 / $181.00 / $181.00	Professional	TC	$181.00	$181.00	$181.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $340.13 / $445.30 / $1,316.55	Professional		$340.13	$445.30	$1,316.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $113.00 / $145.33 / $266.79	Professional	26	$113.00	$145.33	$266.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $227.14 / $301.67 / $1,049.78	Professional	TC	$227.14	$301.67	$1,049.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.22 / $124.22 / $124.22	Facility	26	$124.22	$124.22	$124.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $279.66 / $539.63 / $1,321.23	Professional		$279.66	$539.63	$1,321.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.10 / $156.51 / $284.89	Professional	26	$95.10	$156.51	$284.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.84 / $390.53 / $1,148.72	Professional	TC	$190.84	$390.53	$1,148.72
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $794.00 / $1,016.96 / $1,016.96	Facility	26	$794.00	$1,016.96	$1,016.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $367.40 / $770.68 / $6,195.24	Professional		$367.40	$770.68	$6,195.24
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $116.19 / $164.70 / $931.20	Professional	26	$116.19	$164.70	$931.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $249.24 / $567.42 / $5,551.18	Professional	TC	$249.24	$567.42	$5,551.18
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $197.64 / $197.64 / $197.64	Professional	26	$197.64	$197.64	$197.64
United Facility/Professional Professional Modifier Low / Median / High Price $362.53 / $543.38 / $1,258.97	Professional		$362.53	$543.38	$1,258.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $110.30 / $148.25 / $237.32	Professional	26	$110.30	$148.25	$237.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $236.16 / $350.70 / $902.22	Professional	TC	$236.16	$350.70	$902.22