Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $129.00 / $211.38 / $251.86	Facility	26	$129.00	$211.38	$251.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $537.09 / $847.65	Professional		$475.00	$537.09	$847.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $165.98 / $251.86	Professional	26	$140.00	$165.98	$251.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $393.65 / $595.79	Professional	TC	$335.00	$393.65	$595.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $255.98 / $255.98 / $255.98	Professional		$255.98	$255.98	$255.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.37 / $77.61 / $108.34	Professional	26	$75.37	$77.61	$108.34
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $276.51 / $276.51 / $276.51	Professional	TC	$276.51	$276.51	$276.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $622.00 / $622.00 / $622.00	Professional		$622.00	$622.00	$622.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $284.57 / $575.00 / $1,586.00	Professional		$284.57	$575.00	$1,586.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.33 / $135.68 / $191.56	Professional	26	$85.33	$135.68	$191.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.79 / $447.58 / $1,408.00	Professional	TC	$223.79	$447.58	$1,408.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $742.64 / $950.80 / $950.80	Facility	26	$742.64	$950.80	$950.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $408.62 / $874.90 / $5,981.06	Professional		$408.62	$874.90	$5,981.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $97.23 / $151.58 / $883.52	Professional	26	$97.23	$151.58	$883.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $293.14 / $777.67 / $5,438.76	Professional	TC	$293.14	$777.67	$5,438.76
United Facility/Professional Professional Modifier Low / Median / High Price $395.54 / $734.59 / $1,433.98	Professional		$395.54	$734.59	$1,433.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.23 / $122.73 / $207.59	Professional	26	$97.23	$122.73	$207.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $286.19 / $486.52 / $1,014.90	Professional	TC	$286.19	$486.52	$1,014.90