Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.45 / $31.45 / $102.54	Facility		$31.45	$31.45	$102.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.62 / $50.62 / $59.68	Facility	26	$50.62	$50.62	$59.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.85 / $102.54 / $238.29	Professional		$56.85	$102.54	$238.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.40 / $55.15 / $81.34	Professional	26	$34.40	$55.15	$81.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.15 / $38.63 / $148.65	Professional	TC	$25.15	$38.63	$148.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.89 / $31.89 / $81.93	Professional		$31.89	$31.89	$81.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.04 / $146.84 / $172.75	Professional		$127.04	$146.84	$172.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.40 / $121.60 / $325.00	Professional		$74.40	$121.60	$325.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.20 / $67.69 / $153.72	Professional	26	$42.20	$67.69	$153.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.20 / $52.88 / $196.00	Professional	TC	$32.20	$52.88	$196.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.93 / $143.00 / $458.00	Facility		$61.93	$143.00	$458.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $133.40 / $133.40 / $133.40	Facility	26	$133.40	$133.40	$133.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $73.73 / $241.71 / $1,317.18	Professional		$73.73	$241.71	$1,317.18
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $42.78 / $92.80 / $638.00	Professional	26	$42.78	$92.80	$638.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.95 / $148.91 / $870.88	Professional	TC	$30.95	$148.91	$870.88
United Facility/Professional Facility Modifier Low / Median / High Price $117.75 / $406.00 / $1,661.00	Facility		$117.75	$406.00	$1,661.00
United Facility/Professional Professional Modifier Low / Median / High Price $68.98 / $110.39 / $267.76	Professional		$68.98	$110.39	$267.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.70 / $64.06 / $103.68	Professional	26	$39.70	$64.06	$103.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.95 / $45.95 / $169.41	Professional	TC	$28.95	$45.95	$169.41