Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.96 / $551.00 / $858.37	Facility		$131.96	$551.00	$858.37
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.41 / $27.15 / $33.61	Facility	26	$22.41	$27.15	$33.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.00 / $136.93 / $584.25	Professional		$106.00	$136.93	$584.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.48 / $27.79 / $71.00	Professional	26	$18.48	$27.79	$71.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $206.46 / $206.46 / $206.46	Professional	50	$206.46	$206.46	$206.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.53 / $108.37 / $232.07	Professional	TC	$95.53	$108.37	$232.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.19 / $105.11 / $215.97	Professional		$100.19	$105.11	$215.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.55 / $22.97 / $32.08	Professional	26	$16.55	$22.97	$32.08
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $135.16 / $135.16 / $135.16	Professional	TC	$135.16	$135.16	$135.16
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 $127.03 / $158.57 / $231.18	Professional		$127.03	$158.57	$231.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.10 / $28.19 / $41.36	Professional	26	$22.10	$28.19	$41.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.00 / $129.35 / $189.80	Professional	TC	$102.00	$129.35	$189.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.95 / $412.94 / $648.66	Facility		$186.95	$412.94	$648.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.35 / $26.35 / $26.35	Facility	26	$26.35	$26.35	$26.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.66 / $206.17 / $382.17	Professional		$134.66	$206.17	$382.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.98 / $31.38 / $56.27	Professional	26	$21.98	$31.38	$56.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $115.39 / $180.49 / $337.19	Professional	TC	$115.39	$180.49	$337.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $124.35 / $183.78 / $335.12	Facility		$124.35	$183.78	$335.12
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $52.93 / $161.00 / $161.00	Facility	26	$52.93	$161.00	$161.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $153.02 / $215.70 / $1,223.39	Professional		$153.02	$215.70	$1,223.39
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.79 / $34.76 / $237.75	Professional	26	$19.79	$34.76	$237.75
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $128.12 / $190.80 / $1,114.63	Professional	TC	$128.12	$190.80	$1,114.63
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $185.86 / $185.86 / $185.86	Professional		$185.86	$185.86	$185.86
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $31.76 / $31.76	Professional	26	$31.76	$31.76	$31.76
United Facility/Professional Professional Modifier Low / Median / High Price $142.31 / $192.49 / $320.77	Professional		$142.31	$192.49	$320.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.73 / $30.42 / $51.35	Professional	26	$19.73	$30.42	$51.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $121.71 / $165.89 / $301.58	Professional	TC	$121.71	$165.89	$301.58