Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $524.81 / $630.96	Facility		$141.25	$524.81	$630.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $22.91 / $54.95	Facility	26	$22.91	$22.91	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $141.25 / $407.38	Professional		$107.15	$141.25	$407.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $29.51 / $70.79	Professional	26	$20.89	$29.51	$70.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $102.33 / $213.80	Professional	TC	$83.18	$102.33	$213.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $91.20 / $177.83	Professional		$87.10	$91.20	$177.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $23.99 / $38.90	Professional	26	$16.98	$23.99	$38.90
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $120.23 / $147.91	Professional	TC	$120.23	$120.23	$147.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $1,479.11 / $1,479.11	Facility		$1,479.11	$1,479.11	$1,479.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $141.25 / $223.87	Professional		$114.82	$141.25	$223.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $28.84 / $43.65	Professional	26	$23.99	$28.84	$43.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $112.20 / $173.78	Professional	TC	$89.13	$112.20	$173.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $138.04 / $204.17	Professional		$117.49	$138.04	$204.17
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $28.18 / $37.15	Professional	26	$23.44	$28.18	$37.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $109.65 / $165.96	Professional	TC	$91.20	$109.65	$165.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $346.74 / $512.86	Facility		$186.21	$346.74	$512.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $177.83 / $323.59	Professional		$109.65	$177.83	$323.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $31.62 / $63.10	Professional	26	$22.39	$31.62	$63.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $147.91 / $281.84	Professional	TC	$91.20	$147.91	$281.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $165.96 / $331.13	Facility		$109.65	$165.96	$331.13
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $104.71 / $104.71	Facility	26	$53.70	$104.71	$104.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $181.97 / $1,023.29	Professional		$114.82	$181.97	$1,023.29
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $35.48 / $218.78	Professional	26	$22.39	$35.48	$218.78
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $147.91 / $891.25	Professional	TC	$91.20	$147.91	$891.25
United Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $123.03 / $549.54	Facility		$25.12	$123.03	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $147.91 / $234.42	Professional		$112.20	$147.91	$234.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $26.92 / $44.67	Professional	26	$20.89	$26.92	$44.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $117.49 / $190.55	Professional	TC	$89.13	$117.49	$190.55