Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.03 / $130.68 / $174.34	Facility	26	$89.03	$130.68	$174.34
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $55.09 / $97.52 / $180.09	Facility	53	$55.09	$97.52	$180.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $279.27 / $370.50 / $489.16	Professional		$279.27	$370.50	$489.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.03 / $116.83 / $174.34	Professional	26	$89.03	$116.83	$174.34
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $139.63 / $163.58 / $244.58	Professional	52	$139.63	$163.58	$244.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.10 / $259.35 / $365.85	Professional	TC	$181.10	$259.35	$365.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $142.94 / $142.94 / $330.56	Professional		$142.94	$142.94	$330.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.70 / $52.30 / $74.31	Professional	26	$51.70	$52.30	$74.31
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $91.25 / $148.28 / $148.28	Professional	TC	$91.25	$148.28	$148.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $458.02 / $458.02 / $458.02	Professional		$458.02	$458.02	$458.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.09 / $357.62 / $826.00	Professional		$165.09	$357.62	$826.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.83 / $100.28 / $183.00	Professional	26	$58.83	$100.28	$183.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.57 / $237.99 / $643.00	Professional	TC	$117.57	$237.99	$643.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $507.76 / $656.72 / $656.72	Facility	26	$507.76	$656.72	$656.72
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $117.72 / $285.58 / $285.58	Facility	53	$117.72	$285.58	$285.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $231.99 / $526.37 / $2,872.81	Professional		$231.99	$526.37	$2,872.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $67.09 / $100.27 / $584.49	Professional	26	$67.09	$100.27	$584.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $154.15 / $459.28 / $2,498.98	Professional	TC	$154.15	$459.28	$2,498.98
United Facility/Professional Professional Modifier Low / Median / High Price $226.64 / $378.58 / $611.90	Professional		$226.64	$378.58	$611.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.09 / $84.79 / $144.54	Professional	26	$67.09	$84.79	$144.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $150.49 / $240.78 / $507.62	Professional	TC	$150.49	$240.78	$507.62