Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $142.36 / $157.61 / $229.78	Facility	26	$142.36	$157.61	$229.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $369.45 / $480.36 / $2,125.61	Professional		$369.45	$480.36	$2,125.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.14 / $173.28 / $544.44	Professional	26	$112.14	$173.28	$544.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $271.19 / $335.00 / $1,438.72	Professional	TC	$271.19	$335.00	$1,438.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $225.12 / $225.12 / $238.95	Professional		$225.12	$225.12	$238.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $82.96 / $113.70 / $171.86	Professional	26	$82.96	$113.70	$171.86
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 $338.58 / $443.70 / $1,293.18	Professional		$338.58	$443.70	$1,293.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $113.00 / $145.33 / $244.02	Professional	26	$113.00	$145.33	$244.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $225.58 / $299.61 / $1,049.13	Professional	TC	$225.58	$299.61	$1,049.13
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 $278.55 / $550.00 / $1,324.43	Professional		$278.55	$550.00	$1,324.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.10 / $157.61 / $270.43	Professional	26	$95.10	$157.61	$270.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $189.69 / $388.18 / $1,148.72	Professional	TC	$189.69	$388.18	$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 $365.94 / $805.82 / $6,146.58	Professional		$365.94	$805.82	$6,146.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $115.17 / $161.51 / $921.60	Professional	26	$115.17	$161.51	$921.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $247.83 / $614.28 / $5,551.18	Professional	TC	$247.83	$614.28	$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 $316.89 / $525.03 / $1,525.64	Professional		$316.89	$525.03	$1,525.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.64 / $138.40 / $234.58	Professional	26	$107.64	$138.40	$234.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $242.52 / $362.11 / $918.48	Professional	TC	$242.52	$362.11	$918.48