Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $415.61 / $415.61 / $921.96	Facility		$415.61	$415.61	$921.96
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $711.32 / $711.32 / $711.32	Facility	TC	$711.32	$711.32	$711.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.47 / $264.87 / $572.12	Professional		$220.47	$264.87	$572.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.98 / $125.58 / $509.82	Professional	26	$67.98	$125.58	$509.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $152.06 / $175.40 / $370.54	Professional	TC	$152.06	$175.40	$370.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.02 / $360.98 / $439.71	Professional		$128.02	$360.98	$439.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.97 / $51.67 / $124.39	Professional	26	$33.97	$51.67	$124.39
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $235.00 / $235.00 / $235.00	Professional	TC	$235.00	$235.00	$235.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $214.89 / $343.41 / $461.70	Professional		$214.89	$343.41	$461.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $73.03 / $133.60 / $162.08	Professional	26	$73.03	$133.60	$162.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.81 / $209.81 / $326.77	Professional	TC	$69.81	$209.81	$326.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.26 / $154.02 / $475.97	Professional		$113.26	$154.02	$475.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.84 / $77.69 / $250.08	Professional	26	$38.84	$77.69	$250.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.10 / $106.02 / $260.41	Professional	TC	$61.10	$106.02	$260.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $191.35 / $277.73 / $637.14	Facility		$191.35	$277.73	$637.14
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $358.77 / $358.77 / $358.77	Facility	26	$358.77	$358.77	$358.77
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $943.11 / $943.11 / $943.11	Facility	TC	$943.11	$943.11	$943.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $168.90 / $329.35 / $1,813.36	Professional		$168.90	$329.35	$1,813.36
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $53.52 / $101.68 / $509.36	Professional	26	$53.52	$101.68	$509.36
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $116.93 / $245.25 / $1,303.99	Professional	TC	$116.93	$245.25	$1,303.99
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $136.21 / $136.21 / $151.74	Professional	26	$136.21	$136.21	$151.74
United Facility/Professional Professional Modifier Low / Median / High Price $168.90 / $272.36 / $528.38	Professional		$168.90	$272.36	$528.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.99 / $85.68 / $170.10	Professional	26	$47.99	$85.68	$170.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $108.06 / $174.76 / $355.14	Professional	TC	$108.06	$174.76	$355.14