Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.71 / $568.41 / $1,000.82	Facility		$120.71	$568.41	$1,000.82
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.03 / $25.01 / $32.56	Facility	26	$21.03	$25.01	$32.56
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $99.00 / $278.69 / $592.70	Facility	TC	$99.00	$278.69	$592.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.68 / $127.14 / $431.12	Professional		$26.68	$127.14	$431.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.41 / $31.20 / $90.29	Professional	26	$20.41	$31.20	$90.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.84 / $106.95 / $284.31	Professional	TC	$88.84	$106.95	$284.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.48 / $87.50 / $123.22	Professional		$80.48	$87.50	$123.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.35 / $19.39 / $31.11	Professional	26	$15.35	$19.39	$31.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $63.51 / $97.81 / $153.38	Professional	TC	$63.51	$97.81	$153.38
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 $115.32 / $148.78 / $227.59	Professional		$115.32	$148.78	$227.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.21 / $28.91 / $46.44	Professional	26	$22.21	$28.91	$46.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $92.03 / $114.57 / $181.20	Professional	TC	$92.03	$114.57	$181.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.95 / $364.01 / $512.32	Facility		$186.95	$364.01	$512.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.98 / $23.98 / $23.98	Facility	26	$23.98	$23.98	$23.98
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $109.98 / $109.98 / $109.98	Facility	TC	$109.98	$109.98	$109.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.92 / $171.67 / $310.64	Professional		$113.92	$171.67	$310.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.78 / $30.79 / $51.15	Professional	26	$20.78	$30.79	$51.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.51 / $145.90 / $264.29	Professional	TC	$93.51	$145.90	$264.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $116.20 / $178.49 / $480.90	Facility		$116.20	$178.49	$480.90
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $48.87 / $107.00 / $107.00	Facility	26	$48.87	$107.00	$107.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $195.28 / $442.03 / $442.03	Facility	TC	$195.28	$442.03	$442.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $124.15 / $177.38 / $1,052.95	Professional		$124.15	$177.38	$1,052.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.40 / $32.71 / $237.75	Professional	26	$21.40	$32.71	$237.75
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $101.41 / $149.34 / $927.48	Professional	TC	$101.41	$149.34	$927.48
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $155.19 / $155.19 / $155.19	Professional		$155.19	$155.19	$155.19
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $29.43 / $29.43 / $29.43	Professional	26	$29.43	$29.43	$29.43
United Facility/Professional Professional Modifier Low / Median / High Price $117.94 / $154.19 / $274.54	Professional		$117.94	$154.19	$274.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.14 / $28.39 / $55.43	Professional	26	$21.14	$28.39	$55.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.17 / $128.21 / $239.84	Professional	TC	$98.17	$128.21	$239.84