Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $151.36 / $354.81	Facility	26	$53.70	$151.36	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $257.04 / $831.76	Professional		$128.82	$257.04	$831.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $61.66 / $194.98	Professional	26	$38.02	$61.66	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $169.82 / $426.58	Professional	TC	$87.10	$169.82	$426.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $107.15 / $144.54	Professional		$87.10	$107.15	$144.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $37.15 / $70.79	Professional	26	$30.20	$37.15	$70.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $66.07 / $173.78	Professional	TC	$61.66	$66.07	$173.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $165.96 / $295.12	Professional		$128.82	$165.96	$295.12
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $45.71 / $81.28	Professional	26	$35.48	$45.71	$81.28
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $120.23 / $213.80	Professional	TC	$93.33	$120.23	$213.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $46.77 / $66.07	Facility	26	$10.00	$46.77	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $208.93 / $398.11	Professional		$107.15	$208.93	$398.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $54.95 / $100.00	Professional	26	$30.90	$54.95	$100.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $147.91 / $288.40	Professional	TC	$75.86	$147.91	$288.40
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $295.12 / $380.19 / $380.19	Facility	26	$295.12	$380.19	$380.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $234.42 / $1,412.54	Professional		$120.23	$234.42	$1,412.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $52.48 / $331.13	Professional	26	$37.15	$52.48	$331.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $177.83 / $1,230.27	Professional	TC	$83.18	$177.83	$1,230.27
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $199.53 / $302.00	Professional		$120.23	$199.53	$302.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $46.77 / $79.43	Professional	26	$37.15	$46.77	$79.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $144.54 / $223.87	Professional	TC	$83.18	$144.54	$223.87