Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $202.71 / $757.75 / $1,924.82	Facility		$202.71	$757.75	$1,924.82
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.72 / $38.57 / $49.09	Facility	26	$32.72	$38.57	$49.09
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $150.63 / $301.27 / $627.26	Facility	TC	$150.63	$301.27	$627.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.71 / $233.70 / $607.87	Professional		$176.71	$233.70	$607.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.74 / $40.59 / $134.41	Professional	26	$30.74	$40.59	$134.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $143.38 / $169.96 / $427.06	Professional	TC	$143.38	$169.96	$427.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.59 / $149.52 / $200.26	Professional		$130.59	$149.52	$200.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.74 / $32.40 / $45.93	Professional	26	$23.74	$32.40	$45.93
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $127.09 / $252.34 / $252.34	Professional	TC	$127.09	$252.34	$252.34
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 $184.63 / $234.27 / $365.29	Professional		$184.63	$234.27	$365.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.34 / $44.03 / $71.23	Professional	26	$34.34	$44.03	$71.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $148.56 / $184.23 / $274.69	Professional	TC	$148.56	$184.23	$274.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $273.76 / $585.42 / $912.30	Facility		$273.76	$585.42	$912.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.51 / $37.51 / $37.51	Facility	26	$37.51	$37.51	$37.51
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $172.98 / $172.98 / $172.98	Facility	TC	$172.98	$172.98	$172.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.02 / $270.24 / $497.16	Professional		$179.02	$270.24	$497.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.14 / $47.64 / $80.41	Professional	26	$32.14	$47.64	$80.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.08 / $232.85 / $427.07	Professional	TC	$147.08	$232.85	$427.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $183.37 / $273.57 / $603.29	Facility		$183.37	$273.57	$603.29
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $75.65 / $212.00 / $212.00	Facility	26	$75.65	$212.00	$212.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $305.67 / $691.80 / $691.80	Facility	TC	$305.67	$691.80	$691.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $198.85 / $286.14 / $1,578.90	Professional		$198.85	$286.14	$1,578.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.89 / $50.39 / $889.65	Professional	26	$32.89	$50.39	$889.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $163.47 / $235.81 / $1,388.59	Professional	TC	$163.47	$235.81	$1,388.59
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $242.37 / $242.37 / $242.37	Professional		$242.37	$242.37	$242.37
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $45.52 / $45.52 / $45.52	Professional	26	$45.52	$45.52	$45.52
United Facility/Professional Professional Modifier Low / Median / High Price $187.90 / $252.04 / $472.48	Professional		$187.90	$252.04	$472.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.22 / $43.81 / $85.02	Professional	26	$32.22	$43.81	$85.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.26 / $210.45 / $348.53	Professional	TC	$158.26	$210.45	$348.53