Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.07 / $138.00 / $237.90	Facility	26	$125.07	$138.00	$237.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.91 / $381.98 / $1,721.41	Professional		$282.91	$381.98	$1,721.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.37 / $128.36 / $629.02	Professional	26	$104.37	$128.36	$629.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $176.19 / $246.22 / $974.77	Professional	TC	$176.19	$246.22	$974.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $297.52 / $310.35 / $489.49	Professional		$297.52	$310.35	$489.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $82.91 / $125.08 / $167.49	Professional	26	$82.91	$125.08	$167.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $152.90 / $152.90 / $152.90	Professional	TC	$152.90	$152.90	$152.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $291.58 / $396.60 / $832.83	Professional		$291.58	$396.60	$832.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $117.32 / $145.00 / $250.23	Professional	26	$117.32	$145.00	$250.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $174.26 / $264.47 / $606.66	Professional	TC	$174.26	$264.47	$606.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.28 / $128.28 / $128.28	Facility	26	$128.28	$128.28	$128.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $356.27 / $619.97 / $1,061.71	Professional		$356.27	$619.97	$1,061.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.44 / $159.13 / $281.58	Professional	26	$97.44	$159.13	$281.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $253.62 / $442.72 / $843.74	Professional	TC	$253.62	$442.72	$843.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $815.92 / $1,048.24 / $1,048.24	Facility	26	$815.92	$1,048.24	$1,048.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $440.00 / $663.29 / $4,801.00	Professional		$440.00	$663.29	$4,801.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $119.09 / $161.52 / $1,632.94	Professional	26	$119.09	$161.52	$1,632.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $319.31 / $514.58 / $3,601.00	Professional	TC	$319.31	$514.58	$3,601.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $203.61 / $203.61 / $203.61	Professional	26	$203.61	$203.61	$203.61
United Facility/Professional Professional Modifier Low / Median / High Price $434.41 / $585.91 / $1,017.39	Professional		$434.41	$585.91	$1,017.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.98 / $141.19 / $263.39	Professional	26	$112.98	$141.19	$263.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $296.87 / $412.02 / $743.13	Professional	TC	$296.87	$412.02	$743.13