Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.93 / $159.74 / $308.93	Facility	26	$99.93	$159.74	$308.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.32 / $431.44 / $696.22	Professional		$254.32	$431.44	$696.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.09 / $90.20 / $232.45	Professional	26	$72.09	$90.20	$232.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $179.11 / $318.48 / $509.48	Professional	TC	$179.11	$318.48	$509.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $122.46 / $182.45 / $642.65	Professional		$122.46	$182.45	$642.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.95 / $110.17 / $136.13	Professional	26	$62.95	$110.17	$136.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.89 / $301.60 / $377.00	Professional		$263.89	$301.60	$377.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.90 / $82.17 / $102.71	Professional	26	$71.90	$82.17	$102.71
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $192.00 / $219.43 / $274.29	Professional	TC	$192.00	$219.43	$274.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.56 / $94.56 / $94.56	Facility	26	$94.56	$94.56	$94.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.53 / $521.28 / $834.27	Professional		$229.53	$521.28	$834.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.96 / $100.35 / $177.83	Professional	26	$59.96	$100.35	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $166.81 / $394.31 / $673.27	Professional	TC	$166.81	$394.31	$673.27
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $773.84 / $773.84 / $773.84	Facility	26	$773.84	$773.84	$773.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $255.84 / $528.57 / $3,248.56	Professional		$255.84	$528.57	$3,248.56
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $71.84 / $89.50 / $880.00	Professional	26	$71.84	$89.50	$880.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $179.76 / $453.75 / $2,762.21	Professional	TC	$179.76	$453.75	$2,762.21
United Facility/Professional Professional Modifier Low / Median / High Price $251.97 / $442.02 / $671.84	Professional		$251.97	$442.02	$671.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.84 / $76.26 / $157.52	Professional	26	$71.84	$76.26	$157.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $175.71 / $322.11 / $524.02	Professional	TC	$175.71	$322.11	$524.02