Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $206.37 / $415.72 / $813.46	Facility		$206.37	$415.72	$813.46
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.76 / $56.23 / $61.28	Facility	26	$39.76	$56.23	$61.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.96 / $211.81 / $636.25	Professional		$140.96	$211.81	$636.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.42 / $56.23 / $208.60	Professional	26	$39.42	$56.23	$208.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $264.80 / $264.80 / $367.24	Professional	52	$264.80	$264.80	$367.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.60 / $146.08 / $211.26	Professional	TC	$96.60	$146.08	$211.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $106.78 / $106.78 / $111.19	Professional		$106.78	$106.78	$111.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.20 / $44.55 / $57.69	Professional	26	$34.20	$44.55	$57.69
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $27.89 / $27.89 / $27.89	Professional	52	$27.89	$27.89	$27.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $73.37 / $77.02 / $101.10	Professional	TC	$73.37	$77.02	$101.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $399.00 / $2,195.00 / $3,624.00	Facility		$399.00	$2,195.00	$3,624.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $159.90 / $200.48 / $300.02	Professional		$159.90	$200.48	$300.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.40 / $58.91 / $100.51	Professional	26	$43.40	$58.91	$100.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $103.28 / $141.38 / $212.24	Professional	TC	$103.28	$141.38	$212.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $425.36 / $514.69 / $2,052.00	Facility		$425.36	$514.69	$2,052.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.97 / $237.65 / $360.76	Professional		$138.97	$237.65	$360.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.07 / $68.68 / $100.34	Professional	26	$40.07	$68.68	$100.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.24 / $168.26 / $257.00	Professional	TC	$100.24	$168.26	$257.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $133.25 / $208.69 / $480.94	Facility		$133.25	$208.69	$480.94
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $91.76 / $174.10 / $174.10	Facility	26	$91.76	$174.10	$174.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $152.19 / $238.70 / $1,023.12	Professional		$152.19	$238.70	$1,023.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $42.05 / $65.81 / $261.30	Professional	26	$42.05	$65.81	$261.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $112.64 / $172.36 / $767.60	Professional	TC	$112.64	$172.36	$767.60
United Facility/Professional Professional Modifier Low / Median / High Price $152.01 / $206.02 / $365.72	Professional		$152.01	$206.02	$365.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.72 / $59.24 / $103.28	Professional	26	$41.72	$59.24	$103.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $107.36 / $156.66 / $258.91	Professional	TC	$107.36	$156.66	$258.91