Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.03 / $90.43 / $138.88	Facility	26	$77.03	$90.43	$138.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $160.77 / $225.28 / $268.99	Professional		$160.77	$225.28	$268.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.53 / $75.36 / $94.41	Professional	26	$58.53	$75.36	$94.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $151.28 / $190.14	Professional	TC	$100.00	$151.28	$190.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.83 / $267.86 / $267.86	Professional		$115.83	$267.86	$267.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.98 / $47.23 / $70.29	Professional	26	$44.98	$47.23	$70.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $97.86 / $115.13 / $115.13	Professional	TC	$97.86	$115.13	$115.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $313.00 / $313.00 / $313.00	Professional		$313.00	$313.00	$313.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.56 / $259.16 / $451.95	Professional		$133.56	$259.16	$451.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.32 / $82.37 / $126.00	Professional	26	$51.32	$82.37	$126.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $90.52 / $179.63 / $312.00	Professional	TC	$90.52	$179.63	$312.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $441.84 / $571.36 / $571.36	Facility	26	$441.84	$571.36	$571.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $210.56 / $306.95 / $1,670.68	Professional		$210.56	$306.95	$1,670.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $58.13 / $89.14 / $520.49	Professional	26	$58.13	$89.14	$520.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $141.57 / $231.20 / $1,318.41	Professional	TC	$141.57	$231.20	$1,318.41
United Facility/Professional Professional Modifier Low / Median / High Price $203.55 / $286.08 / $527.16	Professional		$203.55	$286.08	$527.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.13 / $73.80 / $113.98	Professional	26	$58.13	$73.80	$113.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.22 / $207.35 / $269.92	Professional	TC	$138.22	$207.35	$269.92