Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $95.50 / $95.50	Facility	26	$95.50	$95.50	$95.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $512.86 / $1,584.89	Professional		$323.59	$512.86	$1,584.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $131.83 / $457.09	Professional	26	$97.72	$131.83	$457.09
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $151.36 / $302.00 / $426.58	Professional	52	$151.36	$302.00	$426.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $281.84 / $575.44	Professional	TC	$208.93	$281.84	$575.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $316.23 / $416.87	Professional		$275.42	$316.23	$416.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $112.20 / $128.82	Professional	26	$83.18	$112.20	$128.82
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $56.23 / $97.72 / $112.20	Professional	52	$56.23	$97.72	$112.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $288.40 / $288.40	Professional	TC	$288.40	$288.40	$288.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $316.23 / $891.25	Professional		$281.84	$316.23	$891.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $95.50 / $269.15	Professional	26	$85.11	$95.50	$269.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $218.78 / $630.96	Professional	TC	$194.98	$218.78	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $407.38 / $724.44	Professional		$302.00	$407.38	$724.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $134.90 / $218.78	Professional	26	$100.00	$134.90	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $281.84 / $489.78	Professional	TC	$190.55	$281.84	$489.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $263.03 / $467.74	Facility	26	$263.03	$263.03	$467.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $380.19 / $2,691.53	Professional		$281.84	$380.19	$2,691.53
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $125.89 / $776.25	Professional	26	$95.50	$125.89	$776.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $257.04 / $1,905.46	Professional	TC	$181.97	$257.04	$1,905.46
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $346.74 / $676.08	Professional		$281.84	$346.74	$676.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $114.82 / $208.93	Professional	26	$93.33	$114.82	$208.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $234.42 / $478.63	Professional	TC	$181.97	$234.42	$478.63