Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.25 / $62.02 / $84.40	Facility	26	$51.25	$62.02	$84.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.50 / $163.94 / $203.94	Professional		$107.50	$163.94	$203.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.28 / $51.78 / $83.50	Professional	26	$37.28	$51.78	$83.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.44 / $94.74 / $160.87	Professional	TC	$64.44	$94.74	$160.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.79 / $179.89 / $179.89	Professional		$77.79	$179.89	$179.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.82 / $29.89 / $42.87	Professional	26	$29.82	$29.89	$42.87
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $77.95 / $77.95 / $77.95	Professional	TC	$77.95	$77.95	$77.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $244.50 / $244.50 / $244.50	Professional		$244.50	$244.50	$244.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.03 / $175.91 / $378.00	Professional		$89.03	$175.91	$378.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.71 / $57.32 / $107.00	Professional	26	$33.71	$57.32	$107.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.51 / $119.28 / $271.00	Professional	TC	$60.51	$119.28	$271.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $292.88 / $376.16 / $376.16	Facility	26	$292.88	$376.16	$376.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $121.53 / $210.56 / $1,267.82	Professional		$121.53	$210.56	$1,267.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.75 / $59.59 / $315.37	Professional	26	$38.75	$59.59	$315.37
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $75.41 / $171.81 / $1,108.00	Professional	TC	$75.41	$171.81	$1,108.00
United Facility/Professional Professional Modifier Low / Median / High Price $117.29 / $198.13 / $271.92	Professional		$117.29	$198.13	$271.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.75 / $50.30 / $75.13	Professional	26	$38.75	$50.30	$75.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.62 / $110.43 / $192.93	Professional	TC	$73.62	$110.43	$192.93