Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $284.98 / $1,279.14 / $3,444.48	Facility		$284.98	$1,279.14	$3,444.48
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.80 / $94.64 / $124.45	Facility	26	$72.80	$94.64	$124.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.93 / $292.13 / $1,020.00	Professional		$191.93	$292.13	$1,020.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.93 / $80.64 / $278.33	Professional	26	$62.93	$80.64	$278.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $129.05 / $175.12 / $527.12	Professional	TC	$129.05	$175.12	$527.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.68 / $202.02 / $244.71	Professional		$134.68	$202.02	$244.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.35 / $75.52 / $106.34	Professional	26	$50.35	$75.52	$106.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $927.56 / $1,581.58 / $2,478.63	Facility		$927.56	$1,581.58	$2,478.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.33 / $266.56 / $447.52	Professional		$208.33	$266.56	$447.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.98 / $84.67 / $137.26	Professional	26	$68.98	$84.67	$137.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.82 / $184.04 / $299.14	Professional	TC	$138.82	$184.04	$299.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $576.34 / $1,745.64 / $4,462.00	Facility		$576.34	$1,745.64	$4,462.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.01 / $78.01 / $78.01	Facility	26	$78.01	$78.01	$78.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.77 / $301.77 / $556.24	Professional		$194.77	$301.77	$556.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.41 / $97.20 / $181.87	Professional	26	$68.41	$97.20	$181.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $126.36 / $210.17 / $403.61	Professional	TC	$126.36	$210.17	$403.61
Medica Facility/Professional Facility Modifier Low / Median / High Price $208.60 / $342.64 / $1,229.39	Facility		$208.60	$342.64	$1,229.39
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $160.72 / $305.79 / $305.79	Facility	26	$160.72	$305.79	$305.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $211.49 / $367.99 / $3,949.29	Professional		$211.49	$367.99	$3,949.29
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $74.40 / $119.75 / $433.24	Professional	26	$74.40	$119.75	$433.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $136.41 / $251.13 / $1,005.74	Professional	TC	$136.41	$251.13	$1,005.74
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $116.41 / $116.41 / $116.41	Professional	26	$116.41	$116.41	$116.41
United Facility/Professional Professional Modifier Low / Median / High Price $206.46 / $337.50 / $507.13	Professional		$206.46	$337.50	$507.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.19 / $107.66 / $183.10	Professional	26	$74.19	$107.66	$183.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $132.06 / $217.90 / $315.10	Professional	TC	$132.06	$217.90	$315.10