Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $135.53 / $151.65 / $236.64	Facility	26	$135.53	$151.65	$236.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $393.40 / $509.78 / $2,987.36	Professional		$393.40	$509.78	$2,987.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.34 / $169.81 / $547.00	Professional	26	$107.34	$169.81	$547.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $288.42 / $358.13 / $1,607.60	Professional	TC	$288.42	$358.13	$1,607.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.17 / $244.94 / $319.39	Professional		$194.17	$244.94	$319.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.13 / $108.81 / $155.88	Professional	26	$77.13	$108.81	$155.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $199.33 / $199.33 / $199.33	Professional	TC	$199.33	$199.33	$199.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $361.46 / $552.59 / $1,280.28	Professional		$361.46	$552.59	$1,280.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $108.82 / $129.00 / $234.05	Professional	26	$108.82	$129.00	$234.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $252.64 / $402.73 / $1,045.80	Professional	TC	$252.64	$402.73	$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 $294.45 / $616.16 / $1,383.30	Professional		$294.45	$616.16	$1,383.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.99 / $148.91 / $256.60	Professional	26	$90.99	$148.91	$256.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $210.28 / $452.53 / $1,230.84	Professional	TC	$210.28	$452.53	$1,230.84
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 $394.01 / $813.02 / $6,025.38	Professional		$394.01	$813.02	$6,025.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $110.18 / $155.96 / $891.52	Professional	26	$110.18	$155.96	$891.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $280.62 / $655.63 / $5,457.89	Professional	TC	$280.62	$655.63	$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 $382.14 / $579.40 / $1,440.73	Professional		$382.14	$579.40	$1,440.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $105.26 / $133.93 / $223.76	Professional	26	$105.26	$133.93	$223.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $261.18 / $399.66 / $982.59	Professional	TC	$261.18	$399.66	$982.59