Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.43 / $112.00 / $180.46	Facility	26	$96.43	$112.00	$180.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $306.68 / $366.71 / $1,477.00	Professional		$306.68	$366.71	$1,477.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.36 / $104.71 / $317.79	Professional	26	$80.36	$104.71	$317.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $225.84 / $270.86 / $1,155.00	Professional	TC	$225.84	$270.86	$1,155.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.27 / $224.49 / $253.53	Professional		$173.27	$224.49	$253.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.97 / $88.19 / $123.20	Professional	26	$63.97	$88.19	$123.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $154.78 / $154.78 / $337.01	Professional	TC	$154.78	$154.78	$337.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $289.11 / $380.39 / $644.02	Professional		$289.11	$380.39	$644.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $90.32 / $116.24 / $182.50	Professional	26	$90.32	$116.24	$182.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $198.79 / $264.02 / $458.72	Professional	TC	$198.79	$264.02	$458.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.40 / $98.40 / $98.40	Facility	26	$98.40	$98.40	$98.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.36 / $442.33 / $639.26	Professional		$263.36	$442.33	$639.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.79 / $123.20 / $215.07	Professional	26	$74.79	$123.20	$215.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $188.54 / $319.62 / $481.45	Professional	TC	$188.54	$319.62	$481.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $630.16 / $805.76 / $805.76	Facility	26	$630.16	$805.76	$805.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $319.07 / $418.35 / $2,077.84	Professional		$319.07	$418.35	$2,077.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $93.47 / $123.48 / $547.02	Professional	26	$93.47	$123.48	$547.02
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $226.97 / $304.81 / $2,614.00	Professional	TC	$226.97	$304.81	$2,614.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $141.68 / $156.99 / $156.99	Professional	26	$141.68	$156.99	$156.99
United Facility/Professional Professional Modifier Low / Median / High Price $314.06 / $384.99 / $734.85	Professional		$314.06	$384.99	$734.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.88 / $110.89 / $202.77	Professional	26	$87.88	$110.89	$202.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $226.97 / $284.69 / $517.29	Professional	TC	$226.97	$284.69	$517.29