Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.08 / $106.63 / $127.74	Facility	26	$68.08	$106.63	$127.74
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.92 / $57.95 / $201.11	Facility	53	$29.92	$57.95	$201.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $203.32 / $321.72 / $475.00	Professional		$203.32	$321.72	$475.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $88.78 / $140.00	Professional	26	$62.50	$88.78	$140.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $101.66 / $125.00 / $170.89	Professional	52	$101.66	$125.00	$170.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $130.11 / $205.58 / $335.00	Professional	TC	$130.11	$205.58	$335.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.65 / $221.68 / $248.28	Professional		$144.65	$221.68	$248.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.99 / $64.47 / $110.36	Professional	26	$51.99	$64.47	$110.36
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $146.06 / $146.06 / $230.00	Professional	TC	$146.06	$146.06	$230.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.65 / $200.90 / $275.86	Professional		$69.65	$200.90	$275.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.94 / $67.94 / $109.44	Facility	26	$67.94	$67.94	$109.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.25 / $356.13 / $617.04	Professional		$170.25	$356.13	$617.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.62 / $69.83 / $117.61	Professional	26	$60.62	$69.83	$117.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.86 / $225.09 / $526.32	Professional	TC	$107.86	$225.09	$526.32
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 $197.18 / $299.67 / $2,872.81	Professional		$197.18	$299.67	$2,872.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $60.24 / $76.15 / $584.49	Professional	26	$60.24	$76.15	$584.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $130.93 / $297.82 / $2,498.98	Professional	TC	$130.93	$297.82	$2,498.98
United Facility/Professional Professional Modifier Low / Median / High Price $192.64 / $248.82 / $598.04	Professional		$192.64	$248.82	$598.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.24 / $76.04 / $142.19	Professional	26	$60.24	$76.04	$142.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $130.93 / $162.53 / $605.35	Professional	TC	$130.93	$162.53	$605.35