Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $223.87 / $436.52	Facility	26	$181.97	$223.87	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $371.54 / $1,096.48	Professional		$269.15	$371.54	$1,096.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $218.78 / $602.56	Professional	26	$169.82	$218.78	$602.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $114.82 / $204.17	Professional	TC	$93.33	$114.82	$204.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $338.84 / $457.09	Professional		$263.03	$338.84	$457.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $239.88 / $263.03	Professional	26	$162.18	$239.88	$263.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $302.00 / $478.63	Professional		$257.04	$302.00	$478.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $194.98 / $309.03	Professional	26	$162.18	$194.98	$309.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $109.65 / $177.83	Professional	TC	$89.13	$109.65	$177.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $363.08 / $501.19	Professional		$302.00	$363.08	$501.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $229.09 / $323.59	Professional	26	$194.98	$229.09	$323.59
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $131.83 / $177.83	Professional	TC	$107.15	$131.83	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $407.38 / $630.96	Professional		$288.40	$407.38	$630.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $263.03 / $398.11	Professional	26	$186.21	$263.03	$398.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $151.36 / $229.09	Professional	TC	$102.33	$151.36	$229.09
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $426.58 / $831.76 / $831.76	Facility	26	$426.58	$831.76	$831.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $398.11 / $1,862.09	Professional		$281.84	$398.11	$1,862.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $177.83 / $251.19 / $1,174.90	Professional	26	$177.83	$251.19	$1,174.90
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $147.91 / $691.83	Professional	TC	$102.33	$147.91	$691.83
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $426.58	Professional		$389.05	$389.05	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $354.81 / $575.44	Professional		$275.42	$354.81	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $173.78 / $223.87 / $354.81	Professional	26	$173.78	$223.87	$354.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $128.82 / $208.93	Professional	TC	$102.33	$128.82	$208.93