Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $132.01 / $363.08 / $1,185.19	Facility		$132.01	$363.08	$1,185.19
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.35 / $25.46 / $32.03	Facility	26	$21.35	$25.46	$32.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.82 / $178.25 / $403.71	Professional		$117.82	$178.25	$403.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.74 / $26.33 / $76.20	Professional	26	$20.74	$26.33	$76.20
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $59.38 / $66.12 / $110.11	Professional	52	$59.38	$66.12	$110.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.59 / $128.56 / $322.92	Professional	TC	$98.59	$128.56	$322.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.12 / $140.38 / $140.38	Professional		$96.12	$140.38	$140.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.79 / $24.68 / $31.65	Professional	26	$15.79	$24.68	$31.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,423.00 / $1,466.00 / $1,641.00	Facility		$1,423.00	$1,466.00	$1,641.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.62 / $186.00 / $278.74	Professional		$135.62	$186.00	$278.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.13 / $28.91 / $47.25	Professional	26	$23.13	$28.91	$47.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $108.20 / $145.86 / $257.75	Professional	TC	$108.20	$145.86	$257.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $182.08 / $406.40 / $517.05	Facility		$182.08	$406.40	$517.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.72 / $24.72 / $24.72	Facility	26	$24.72	$24.72	$24.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.58 / $192.76 / $337.03	Professional		$124.58	$192.76	$337.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.23 / $31.13 / $55.57	Professional	26	$21.23	$31.13	$55.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $103.67 / $163.30 / $300.79	Professional	TC	$103.67	$163.30	$300.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $124.58 / $186.87 / $402.84	Facility		$124.58	$186.87	$402.84
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $48.94 / $176.87 / $176.87	Facility	26	$48.94	$176.87	$176.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $134.97 / $195.46 / $1,173.20	Professional		$134.97	$195.46	$1,173.20
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.25 / $32.63 / $310.41	Professional	26	$21.25	$32.63	$310.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $112.24 / $168.05 / $1,048.79	Professional	TC	$112.24	$168.05	$1,048.79
United Facility/Professional Professional Modifier Low / Median / High Price $128.22 / $163.98 / $275.05	Professional		$128.22	$163.98	$275.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.47 / $28.39 / $55.45	Professional	26	$20.47	$28.39	$55.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.24 / $142.11 / $253.90	Professional	TC	$112.24	$142.11	$253.90