Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.12 / $62.91 / $92.10	Facility	26	$52.12	$62.91	$92.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.76 / $197.66 / $272.68	Professional		$129.76	$197.66	$272.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.40 / $54.70 / $75.02	Professional	26	$40.40	$54.70	$75.02
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $64.88 / $80.45 / $99.45	Professional	52	$64.88	$80.45	$99.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.36 / $135.15 / $224.66	Professional	TC	$89.36	$135.15	$224.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.03 / $199.80 / $215.14	Professional		$93.03	$199.80	$215.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.06 / $30.12 / $43.21	Professional	26	$30.06	$30.12	$43.21
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $66.91 / $102.32 / $102.32	Professional	TC	$66.91	$102.32	$102.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.37 / $281.37 / $281.37	Professional		$281.37	$281.37	$281.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.34 / $211.95 / $388.00	Professional		$107.34	$211.95	$388.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.44 / $60.94 / $100.00	Professional	26	$35.44	$60.94	$100.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.68 / $158.49 / $288.00	Professional	TC	$79.68	$158.49	$288.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $295.27 / $379.28 / $379.28	Facility	26	$295.27	$379.28	$379.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $146.29 / $254.03 / $1,413.47	Professional		$146.29	$254.03	$1,413.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $46.48 / $65.26 / $333.52	Professional	26	$46.48	$65.26	$333.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $99.81 / $202.73 / $1,220.00	Professional	TC	$99.81	$202.73	$1,220.00
United Facility/Professional Professional Modifier Low / Median / High Price $141.47 / $212.21 / $302.49	Professional		$141.47	$212.21	$302.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.03 / $56.58 / $76.27	Professional	26	$44.03	$56.58	$76.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.44 / $155.66 / $249.90	Professional	TC	$97.44	$155.66	$249.90