Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $135.94 / $150.81 / $237.31	Facility	26	$135.94	$150.81	$237.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $379.62 / $507.87 / $2,985.34	Professional		$379.62	$507.87	$2,985.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.92 / $165.33 / $585.00	Professional	26	$105.92	$165.33	$585.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $299.00 / $356.23 / $1,088.69	Professional	TC	$299.00	$356.23	$1,088.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $178.18 / $236.59 / $318.18	Professional		$178.18	$236.59	$318.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.13 / $116.27 / $155.88	Professional	26	$77.13	$116.27	$155.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $198.22 / $198.22 / $198.22	Professional	TC	$198.22	$198.22	$198.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $361.15 / $552.59 / $1,280.28	Professional		$361.15	$552.59	$1,280.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $108.82 / $129.00 / $234.49	Professional	26	$108.82	$129.00	$234.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $252.33 / $400.58 / $1,045.80	Professional	TC	$252.33	$400.58	$1,045.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.86 / $118.86 / $118.86	Facility	26	$118.86	$118.86	$118.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $293.35 / $615.08 / $1,383.30	Professional		$293.35	$615.08	$1,383.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.28 / $149.35 / $256.60	Professional	26	$91.28	$149.35	$256.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $209.14 / $451.41 / $1,225.47	Professional	TC	$209.14	$451.41	$1,225.47
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $759.68 / $973.04 / $973.04	Facility	26	$759.68	$973.04	$973.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $393.31 / $811.00 / $6,025.38	Professional		$393.31	$811.00	$6,025.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $110.17 / $152.86 / $891.52	Professional	26	$110.17	$152.86	$891.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $279.92 / $653.66 / $5,457.89	Professional	TC	$279.92	$653.66	$5,457.89
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $189.30 / $189.30 / $189.30	Professional	26	$189.30	$189.30	$189.30
United Facility/Professional Professional Modifier Low / Median / High Price $382.65 / $588.63 / $1,438.15	Professional		$382.65	$588.63	$1,438.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $105.26 / $133.93 / $244.30	Professional	26	$105.26	$133.93	$244.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $268.39 / $401.36 / $1,021.48	Professional	TC	$268.39	$401.36	$1,021.48