Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $452.52 / $541.02 / $671.62	Facility	26	$452.52	$541.02	$671.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,405.26 / $2,020.07 / $3,447.60	Professional		$1,405.26	$2,020.07	$3,447.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $279.98 / $452.52 / $714.51	Professional	26	$279.98	$452.52	$714.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $989.87 / $1,567.55 / $2,530.81	Professional	TC	$989.87	$1,567.55	$2,530.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $2,723.99 / $2,723.99 / $3,164.87	Professional		$2,723.99	$2,723.99	$3,164.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $539.08 / $636.10 / $678.34	Professional	26	$539.08	$636.10	$678.34
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $2,088.79 / $2,088.79 / $2,088.79	Professional	TC	$2,088.79	$2,088.79	$2,088.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,855.75 / $2,456.15 / $2,729.05	Professional		$1,855.75	$2,456.15	$2,729.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $429.86 / $568.92 / $632.14	Professional	26	$429.86	$568.92	$632.14
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,425.90 / $1,887.22 / $2,096.91	Professional	TC	$1,425.90	$1,887.22	$2,096.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,759.68 / $2,771.86 / $3,949.65	Professional		$1,759.68	$2,771.86	$3,949.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $409.45 / $630.04 / $870.53	Professional	26	$409.45	$630.04	$870.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,347.59 / $2,141.81 / $3,079.12	Professional	TC	$1,347.59	$2,141.81	$3,079.12
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $3,132.59 / $3,132.59 / $3,639.60	Professional		$3,132.59	$3,132.59	$3,639.60
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $619.94 / $767.92 / $800.99	Professional	26	$619.94	$767.92	$800.99
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $2,402.11 / $2,402.11 / $2,402.11	Professional	TC	$2,402.11	$2,402.11	$2,402.11
United Facility/Professional Professional Modifier Low / Median / High Price $1,565.94 / $1,964.42 / $3,313.64	Professional		$1,565.94	$1,964.42	$3,313.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $376.46 / $461.19 / $775.43	Professional	26	$376.46	$461.19	$775.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,299.25 / $1,630.79 / $2,430.28	Professional	TC	$1,299.25	$1,630.79	$2,430.28