Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.82 / $140.85 / $248.05	Facility	26	$95.82	$140.85	$248.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $311.68 / $475.00 / $1,964.80	Professional		$311.68	$475.00	$1,964.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.82 / $140.00 / $327.22	Professional	26	$95.82	$140.00	$327.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $215.86 / $271.72 / $586.89	Professional	TC	$215.86	$271.72	$586.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $196.80 / $248.14 / $323.70	Professional		$196.80	$248.14	$323.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.23 / $121.86 / $163.40	Professional	26	$81.23	$121.86	$163.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $366.31 / $441.72 / $738.54	Professional		$366.31	$441.72	$738.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $113.36 / $131.27 / $238.37	Professional	26	$113.36	$131.27	$238.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $252.95 / $296.54 / $517.89	Professional	TC	$252.95	$296.54	$517.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.62 / $124.62 / $124.62	Facility	26	$124.62	$124.62	$124.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $313.61 / $510.69 / $806.25	Professional		$313.61	$510.69	$806.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $94.73 / $155.22 / $269.94	Professional	26	$94.73	$155.22	$269.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $209.99 / $353.26 / $573.86	Professional	TC	$209.99	$353.26	$573.86
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $796.48 / $1,020.08 / $1,020.08	Facility	26	$796.48	$1,020.08	$1,020.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $397.30 / $746.29 / $2,337.81	Professional		$397.30	$746.29	$2,337.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $84.75 / $134.97 / $687.65	Professional	26	$84.75	$134.97	$687.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $277.58 / $567.87 / $1,650.16	Professional	TC	$277.58	$567.87	$1,650.16
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $198.28 / $198.28 / $198.28	Professional	26	$198.28	$198.28	$198.28
United Facility/Professional Professional Modifier Low / Median / High Price $387.97 / $579.76 / $1,464.72	Professional		$387.97	$579.76	$1,464.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.24 / $129.02 / $254.50	Professional	26	$88.24	$129.02	$254.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $261.19 / $400.67 / $1,028.75	Professional	TC	$261.19	$400.67	$1,028.75