Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $129.00 / $148.35 / $215.65	Facility	26	$129.00	$148.35	$215.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $382.83 / $584.10 / $2,628.08	Professional		$382.83	$584.10	$2,628.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.36 / $155.58 / $589.01	Professional	26	$109.36	$155.58	$589.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $434.93 / $1,967.74	Professional	TC	$335.00	$434.93	$1,967.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $577.04 / $577.04 / $577.04	Professional		$577.04	$577.04	$577.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.94 / $127.82 / $168.79	Professional	26	$77.94	$127.82	$168.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $415.28 / $543.98 / $1,268.26	Professional		$415.28	$543.98	$1,268.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $106.35 / $124.66 / $222.80	Professional	26	$106.35	$124.66	$222.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $308.93 / $410.31 / $1,045.49	Professional	TC	$308.93	$410.31	$1,045.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.87 / $116.87 / $116.87	Facility	26	$116.87	$116.87	$116.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $336.57 / $651.00 / $1,407.85	Professional		$336.57	$651.00	$1,407.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.84 / $145.65 / $250.28	Professional	26	$88.84	$145.65	$250.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $255.17 / $496.01 / $1,137.35	Professional	TC	$255.17	$496.01	$1,137.35
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $745.12 / $957.12 / $957.12	Facility	26	$745.12	$957.12	$957.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $452.60 / $840.36 / $5,981.06	Professional		$452.60	$840.36	$5,981.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $105.21 / $149.88 / $894.00	Professional	26	$105.21	$149.88	$894.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $338.17 / $656.68 / $5,438.76	Professional	TC	$338.17	$656.68	$5,438.76
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $663.60 / $663.60 / $663.60	Professional		$663.60	$663.60	$663.60
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $185.53 / $185.53 / $185.53	Professional	26	$185.53	$185.53	$185.53
United Facility/Professional Professional Modifier Low / Median / High Price $436.09 / $658.12 / $1,418.25	Professional		$436.09	$658.12	$1,418.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $98.74 / $130.11 / $338.41	Professional	26	$98.74	$130.11	$338.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $317.16 / $479.62 / $1,056.06	Professional	TC	$317.16	$479.62	$1,056.06