Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $115.96 / $162.35 / $237.82	Facility	26	$115.96	$162.35	$237.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $568.95 / $761.38 / $2,538.80	Professional		$568.95	$761.38	$2,538.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $113.37 / $146.12 / $599.42	Professional	26	$113.37	$146.12	$599.42
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $247.60 / $327.29 / $427.46	Professional	52	$247.60	$327.29	$427.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $450.89 / $602.07 / $1,898.73	Professional	TC	$450.89	$602.07	$1,898.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $579.34 / $579.34 / $579.34	Professional		$579.34	$579.34	$579.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $97.30 / $145.41 / $189.12	Professional	26	$97.30	$145.41	$189.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $562.80 / $708.84 / $1,154.43	Professional		$562.80	$708.84	$1,154.43
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $114.27 / $142.22 / $294.08	Professional	26	$114.27	$142.22	$294.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $451.34 / $553.07 / $904.36	Professional	TC	$451.34	$553.07	$904.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $600.00 / $875.82 / $1,308.85	Professional		$600.00	$875.82	$1,308.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $119.79 / $178.91 / $269.17	Professional	26	$119.79	$178.91	$269.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $473.53 / $697.03 / $1,051.52	Professional	TC	$473.53	$697.03	$1,051.52
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $275.57 / $701.13 / $701.13	Facility	26	$275.57	$701.13	$701.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $604.14 / $923.44 / $6,200.00	Professional		$604.14	$923.44	$6,200.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $117.17 / $195.86 / $2,600.00	Professional	26	$117.17	$195.86	$2,600.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $480.72 / $717.09 / $7,000.00	Professional	TC	$480.72	$717.09	$7,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $563.62 / $816.31 / $1,361.33	Professional		$563.62	$816.31	$1,361.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.06 / $168.47 / $301.22	Professional	26	$112.06	$168.47	$301.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $446.93 / $636.79 / $1,095.52	Professional	TC	$446.93	$636.79	$1,095.52