Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.24 / $263.00 / $1,132.63	Facility		$111.24	$263.00	$1,132.63
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.93 / $45.82 / $71.31	Facility	26	$36.93	$45.82	$71.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.73 / $136.33 / $710.00	Professional		$101.73	$136.33	$710.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.61 / $51.52 / $167.90	Professional	26	$33.61	$51.52	$167.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.12 / $99.56 / $454.00	Professional	TC	$68.12	$99.56	$454.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $86.31 / $171.71	Professional		$80.04	$86.31	$171.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.32 / $34.10 / $57.14	Professional	26	$28.32	$34.10	$57.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $59.37 / $64.54 / $127.56	Professional	TC	$59.37	$64.54	$127.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $465.00 / $477.00 / $1,193.00	Facility		$465.00	$477.00	$1,193.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.91 / $140.63 / $238.40	Professional		$110.91	$140.63	$238.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.95 / $49.33 / $79.28	Professional	26	$39.95	$49.33	$79.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.95 / $89.18 / $163.79	Professional	TC	$70.95	$89.18	$163.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $136.69 / $252.46 / $455.25	Facility		$136.69	$252.46	$455.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.62 / $43.62 / $43.62	Facility	26	$43.62	$43.62	$43.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.11 / $153.69 / $257.45	Professional		$97.11	$153.69	$257.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.35 / $51.73 / $93.09	Professional	26	$33.35	$51.73	$93.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.79 / $99.91 / $181.37	Professional	TC	$66.79	$99.91	$181.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $105.21 / $166.65 / $446.36	Facility		$105.21	$166.65	$446.36
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $90.38 / $172.60 / $172.60	Facility	26	$90.38	$172.60	$172.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $119.91 / $154.10 / $760.68	Professional		$119.91	$154.10	$760.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.93 / $50.32 / $303.79	Professional	26	$38.93	$50.32	$303.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $79.20 / $102.77 / $518.02	Professional	TC	$79.20	$102.77	$518.02
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $197.47 / $197.47 / $197.47	Professional		$197.47	$197.47	$197.47
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $69.51 / $69.51 / $69.51	Professional	26	$69.51	$69.51	$69.51
United Facility/Professional Professional Modifier Low / Median / High Price $112.71 / $134.38 / $222.59	Professional		$112.71	$134.38	$222.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.31 / $44.55 / $73.61	Professional	26	$37.31	$44.55	$73.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.58 / $93.41 / $148.81	Professional	TC	$75.58	$93.41	$148.81