Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $233.53 / $675.15 / $2,134.62	Facility		$233.53	$675.15	$2,134.62
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.77 / $44.42 / $55.15	Facility	26	$36.77	$44.42	$55.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $196.77 / $255.80 / $840.30	Facility	TC	$196.77	$255.80	$840.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.31 / $284.05 / $599.19	Professional		$189.31	$284.05	$599.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.05 / $39.67 / $95.05	Professional	26	$30.05	$39.67	$95.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $209.20 / $444.90	Professional	TC	$162.34	$209.20	$444.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $133.99 / $174.87 / $194.50	Professional		$133.99	$174.87	$194.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.55 / $38.03 / $52.62	Professional	26	$27.55	$38.03	$52.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $245.66 / $245.66 / $245.66	Professional	TC	$245.66	$245.66	$245.66
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 $203.67 / $263.55 / $387.63	Professional		$203.67	$263.55	$387.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.97 / $42.70 / $62.58	Professional	26	$33.97	$42.70	$62.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $168.30 / $213.34 / $317.62	Professional	TC	$168.30	$213.34	$317.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $273.76 / $745.48 / $1,004.60	Facility		$273.76	$745.48	$1,004.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.91 / $42.91 / $42.91	Facility	26	$42.91	$42.91	$42.91
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $227.42 / $227.42 / $227.42	Facility	TC	$227.42	$227.42	$227.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.65 / $340.44 / $636.35	Professional		$218.65	$340.44	$636.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.88 / $49.21 / $85.49	Professional	26	$34.88	$49.21	$85.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $193.36 / $304.98 / $572.23	Professional	TC	$193.36	$304.98	$572.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $226.81 / $336.06 / $664.40	Facility		$226.81	$336.06	$664.40
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $86.56 / $205.00 / $205.00	Facility	26	$86.56	$205.00	$205.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $399.93 / $906.68 / $906.68	Facility	TC	$399.93	$906.68	$906.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $256.13 / $363.20 / $1,952.19	Professional		$256.13	$363.20	$1,952.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.66 / $55.81 / $399.57	Professional	26	$29.66	$55.81	$399.57
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $218.70 / $310.49 / $1,791.16	Professional	TC	$218.70	$310.49	$1,791.16
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $309.67 / $309.67 / $309.67	Professional		$309.67	$309.67	$309.67
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $52.10 / $52.10 / $52.10	Professional	26	$52.10	$52.10	$52.10
United Facility/Professional Professional Modifier Low / Median / High Price $240.00 / $322.33 / $615.04	Professional		$240.00	$322.33	$615.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.96 / $47.92 / $84.23	Professional	26	$28.96	$47.92	$84.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $203.39 / $271.20 / $455.26	Professional	TC	$203.39	$271.20	$455.26