Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,162.00 / $2,640.00 / $5,506.00	Facility		$1,162.00	$2,640.00	$5,506.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.37 / $117.37 / $117.37	Facility	26	$117.37	$117.37	$117.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $336.76 / $400.77 / $808.08	Professional		$336.76	$400.77	$808.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.38 / $132.90 / $368.51	Professional	26	$117.38	$132.90	$368.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $219.38 / $244.07 / $447.78	Professional	TC	$219.38	$244.07	$447.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $306.14 / $306.14 / $306.14	Professional		$306.14	$306.14	$306.14
BCBS Facility/Professional Facility Modifier Low / Median / High Price $161.93 / $605.79 / $997.08	Facility		$161.93	$605.79	$997.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $222.56 / $296.74 / $370.93	Professional		$222.56	$296.74	$370.93
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $76.91 / $102.55 / $128.19	Professional	26	$76.91	$102.55	$128.19
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $145.63 / $194.19 / $242.74	Professional	TC	$145.63	$194.19	$242.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $417.14 / $417.14 / $417.14	Facility		$417.14	$417.14	$417.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $324.51 / $429.42 / $774.96	Professional		$324.51	$429.42	$774.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.71 / $160.35 / $276.52	Professional	26	$117.71	$160.35	$276.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $191.60 / $278.00 / $494.85	Professional	TC	$191.60	$278.00	$494.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $340.16 / $506.62 / $2,554.00	Facility		$340.16	$506.62	$2,554.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $319.48 / $319.48 / $564.64	Facility	26	$319.48	$319.48	$564.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $312.48 / $403.88 / $2,844.40	Professional		$312.48	$403.88	$2,844.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $119.68 / $149.99 / $930.32	Professional	26	$119.68	$149.99	$930.32
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $187.20 / $259.37 / $1,914.08	Professional	TC	$187.20	$259.37	$1,914.08
United Facility/Professional Facility Modifier Low / Median / High Price $1,068.00 / $1,525.00 / $3,268.00	Facility		$1,068.00	$1,525.00	$3,268.00
United Facility/Professional Professional Modifier Low / Median / High Price $307.30 / $387.98 / $740.47	Professional		$307.30	$387.98	$740.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $115.94 / $139.62 / $280.19	Professional	26	$115.94	$139.62	$280.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $183.86 / $252.36 / $505.98	Professional	TC	$183.86	$252.36	$505.98