Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $630.96 / $660.69	Facility		$331.13	$630.96	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $162.18 / $501.19	Professional		$67.61	$162.18	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $69.18 / $354.81	Professional	26	$28.84	$69.18	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $77.62 / $295.12	Professional	TC	$45.71	$77.62	$295.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $66.07 / $141.25	Professional		$46.77	$66.07	$141.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $31.62 / $47.86	Professional	26	$14.45	$31.62	$47.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $69.18 / $75.86	Professional	TC	$34.67	$69.18	$75.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $112.20 / $181.97	Professional		$85.11	$112.20	$181.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $56.23 / $81.28	Professional	26	$31.62	$56.23	$81.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $69.18 / $107.15	Professional	TC	$50.12	$69.18	$107.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $112.20 / $177.83	Professional		$102.33	$112.20	$177.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $41.69 / $79.43	Professional	26	$31.62	$41.69	$79.43
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $69.18 / $123.03	Professional	TC	$60.26	$69.18	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $58.88 / $234.42	Professional		$46.77	$58.88	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $28.84 / $114.82	Professional	26	$16.60	$28.84	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $38.90 / $114.82	Professional	TC	$27.54	$38.90	$114.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $109.65 / $218.78	Facility		$83.18	$109.65	$218.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $169.82 / $169.82 / $169.82	Facility	26	$169.82	$169.82	$169.82
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $354.81 / $354.81 / $354.81	Facility	TC	$354.81	$354.81	$354.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $141.25 / $660.69	Professional		$64.57	$141.25	$660.69
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $47.86 / $275.42	Professional	26	$23.99	$47.86	$275.42
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $89.13 / $426.58	Professional	TC	$42.66	$89.13	$426.58
United Facility/Professional Facility Modifier Low / Median / High Price $16.22 / $38.02 / $54.95	Facility		$16.22	$38.02	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $104.71 / $194.98	Professional		$58.88	$104.71	$194.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $37.15 / $74.13	Professional	26	$21.38	$37.15	$74.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $67.61 / $128.82	Professional	TC	$38.90	$67.61	$128.82