Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.45 / $135.77 / $243.63	Facility	26	$98.45	$135.77	$243.63
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $38.11 / $62.20 / $122.71	Facility	53	$38.11	$62.20	$122.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $222.36 / $475.00 / $982.25	Professional		$222.36	$475.00	$982.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.51 / $140.00 / $322.00	Professional	26	$70.51	$140.00	$322.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $104.28 / $187.50 / $237.50	Professional	52	$104.28	$187.50	$237.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $335.00 / $422.10	Professional	TC	$187.50	$335.00	$422.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $137.00 / $174.28 / $199.99	Professional		$137.00	$174.28	$199.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.22 / $66.52 / $123.42	Professional	26	$53.22	$66.52	$123.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $196.69 / $224.78 / $280.98	Professional		$196.69	$224.78	$280.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.73 / $69.45 / $86.83	Professional	26	$67.73	$69.45	$86.83
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $135.91 / $155.32 / $194.15	Professional	TC	$135.91	$155.32	$194.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.26 / $80.26 / $80.26	Facility	26	$80.26	$80.26	$80.26
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $45.11 / $45.11 / $45.11	Facility	53	$45.11	$45.11	$45.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.52 / $408.62 / $692.49	Professional		$164.52	$408.62	$692.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.87 / $87.87 / $149.94	Professional	26	$51.87	$87.87	$149.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $110.25 / $277.74 / $581.60	Professional	TC	$110.25	$277.74	$581.60
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $656.72 / $656.72 / $656.72	Facility	26	$656.72	$656.72	$656.72
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $285.58 / $285.58 / $285.58	Facility	53	$285.58	$285.58	$285.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $192.64 / $477.81 / $2,872.81	Professional		$192.64	$477.81	$2,872.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $60.24 / $75.95 / $584.49	Professional	26	$60.24	$75.95	$584.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $127.91 / $351.23 / $2,498.98	Professional	TC	$127.91	$351.23	$2,498.98
United Facility/Professional Professional Modifier Low / Median / High Price $192.64 / $332.84 / $541.08	Professional		$192.64	$332.84	$541.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.24 / $64.73 / $134.65	Professional	26	$60.24	$64.73	$134.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $127.91 / $283.79 / $598.51	Professional	TC	$127.91	$283.79	$598.51