Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.70 / $125.98 / $244.88	Facility	26	$86.70	$125.98	$244.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $192.02 / $312.27 / $909.91	Professional		$192.02	$312.27	$909.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.34 / $78.81 / $254.79	Professional	26	$59.34	$78.81	$254.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $122.00 / $221.81 / $364.25	Professional	TC	$122.00	$221.81	$364.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.88 / $163.22 / $241.28	Professional		$138.88	$163.22	$241.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $49.39 / $75.23 / $115.32	Professional	26	$49.39	$75.23	$115.32
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $66.33 / $66.33 / $126.89	Professional	TC	$66.33	$66.33	$126.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $184.25 / $210.57 / $263.20	Professional		$184.25	$210.57	$263.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.71 / $64.81 / $81.01	Professional	26	$56.71	$64.81	$81.01
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $127.54 / $145.76 / $182.20	Professional	TC	$127.54	$145.76	$182.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.84 / $74.84 / $74.84	Facility	26	$74.84	$74.84	$74.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.15 / $283.86 / $477.20	Professional		$154.15	$283.86	$477.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.42 / $79.48 / $139.60	Professional	26	$48.42	$79.48	$139.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $103.59 / $213.27 / $357.16	Professional	TC	$103.59	$213.27	$357.16
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $612.88 / $612.88 / $612.88	Facility	26	$612.88	$612.88	$612.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $174.85 / $278.94 / $1,680.90	Professional		$174.85	$278.94	$1,680.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $56.37 / $70.73 / $414.94	Professional	26	$56.37	$70.73	$414.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $114.72 / $222.57 / $1,425.00	Professional	TC	$114.72	$222.57	$1,425.00
United Facility/Professional Professional Modifier Low / Median / High Price $174.85 / $251.94 / $457.06	Professional		$174.85	$251.94	$457.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.37 / $60.26 / $126.00	Professional	26	$56.37	$60.26	$126.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $114.72 / $193.55 / $297.55	Professional	TC	$114.72	$193.55	$297.55