Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.80 / $121.95 / $197.84	Facility	26	$105.80	$121.95	$197.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.12 / $434.02 / $1,847.00	Professional		$347.12	$434.02	$1,847.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.17 / $117.22 / $326.39	Professional	26	$88.17	$117.22	$326.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.19 / $328.03 / $1,372.00	Professional	TC	$259.19	$328.03	$1,372.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $193.91 / $255.19 / $318.99	Professional		$193.91	$255.19	$318.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $70.29 / $99.01 / $150.03	Professional	26	$70.29	$99.01	$150.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $207.39 / $207.39 / $385.94	Professional	TC	$207.39	$207.39	$385.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $326.22 / $429.10 / $790.22	Professional		$326.22	$429.10	$790.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $99.08 / $128.97 / $202.12	Professional	26	$99.08	$128.97	$202.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $227.14 / $301.67 / $606.25	Professional	TC	$227.14	$301.67	$606.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.46 / $108.46 / $108.46	Facility	26	$108.46	$108.46	$108.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $300.00 / $505.52 / $778.13	Professional		$300.00	$505.52	$778.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.53 / $135.18 / $237.42	Professional	26	$82.53	$135.18	$237.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.01 / $368.79 / $595.32	Professional	TC	$213.01	$368.79	$595.32
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $690.96 / $887.84 / $887.84	Facility	26	$690.96	$887.84	$887.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $361.28 / $497.53 / $2,326.86	Professional		$361.28	$497.53	$2,326.86
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $101.34 / $125.28 / $600.70	Professional	26	$101.34	$125.28	$600.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $259.94 / $371.65 / $2,909.00	Professional	TC	$259.94	$371.65	$2,909.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $172.53 / $172.53 / $172.53	Professional	26	$172.53	$172.53	$172.53
United Facility/Professional Professional Modifier Low / Median / High Price $354.86 / $461.99 / $748.07	Professional		$354.86	$461.99	$748.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $94.07 / $122.91 / $222.43	Professional	26	$94.07	$122.91	$222.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $252.37 / $335.45 / $542.25	Professional	TC	$252.37	$335.45	$542.25