Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.51 / $117.49 / $246.10	Facility	26	$73.51	$117.49	$246.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $253.60 / $392.75	Professional		$171.00	$253.60	$392.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $64.70 / $168.59	Professional	26	$55.00	$64.70	$168.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $106.43 / $177.61 / $291.63	Professional	TC	$106.43	$177.61	$291.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.75 / $133.30 / $150.69	Professional		$104.75	$133.30	$150.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.83 / $70.09 / $100.13	Professional	26	$46.83	$70.09	$100.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $47.86 / $47.86	Professional	TC	$47.86	$47.86	$47.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $149.09 / $170.39 / $212.99	Professional		$149.09	$170.39	$212.99
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.89 / $60.45 / $75.56	Professional	26	$52.89	$60.45	$75.56
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $96.20 / $109.94 / $137.43	Professional	TC	$96.20	$109.94	$137.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.44 / $69.44 / $69.44	Facility	26	$69.44	$69.44	$69.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.82 / $235.56 / $391.00	Professional		$130.82	$235.56	$391.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.95 / $73.81 / $129.88	Professional	26	$44.95	$73.81	$129.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.04 / $171.92 / $285.00	Professional	TC	$78.04	$171.92	$285.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $568.24 / $568.24 / $568.24	Facility	26	$568.24	$568.24	$568.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $142.03 / $233.84 / $1,403.43	Professional		$142.03	$233.84	$1,403.43
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $52.50 / $62.40 / $384.88	Professional	26	$52.50	$62.40	$384.88
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $86.20 / $180.57 / $1,332.00	Professional	TC	$86.20	$180.57	$1,332.00
United Facility/Professional Professional Modifier Low / Median / High Price $142.03 / $208.02 / $353.35	Professional		$142.03	$208.02	$353.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.50 / $55.83 / $118.95	Professional	26	$52.50	$55.83	$118.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.20 / $148.91 / $226.36	Professional	TC	$86.20	$148.91	$226.36