Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $136.65 / $210.16 / $404.49	Facility	26	$136.65	$210.16	$404.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $334.68 / $475.00 / $1,287.97	Professional		$334.68	$475.00	$1,287.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $154.00 / $498.26	Professional	26	$111.15	$154.00	$498.26
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $125.00 / $202.92 / $278.89	Professional	52	$125.00	$202.92	$278.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $236.47 / $335.00 / $572.35	Professional	TC	$236.47	$335.00	$572.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $222.56 / $270.25 / $319.76	Professional		$222.56	$270.25	$319.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $82.45 / $144.94 / $191.37	Professional	26	$82.45	$144.94	$191.37
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $203.93 / $203.93 / $203.93	Professional	TC	$203.93	$203.93	$203.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $320.08 / $365.81 / $457.26	Professional		$320.08	$365.81	$457.26
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.60 / $108.11 / $135.13	Professional	26	$94.60	$108.11	$135.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $225.48 / $257.70 / $322.12	Professional	TC	$225.48	$257.70	$322.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.88 / $123.88 / $123.88	Facility	26	$123.88	$123.88	$123.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.08 / $642.59 / $1,174.21	Professional		$267.08	$642.59	$1,174.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.04 / $136.88 / $235.95	Professional	26	$80.04	$136.88	$235.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $183.57 / $426.21 / $994.34	Professional	TC	$183.57	$426.21	$994.34
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $1,013.76 / $1,013.76 / $1,013.76	Facility	26	$1,013.76	$1,013.76	$1,013.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $315.04 / $724.72 / $6,146.58	Professional		$315.04	$724.72	$6,146.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $95.99 / $117.29 / $921.60	Professional	26	$95.99	$117.29	$921.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $215.34 / $542.35 / $5,551.18	Professional	TC	$215.34	$542.35	$5,551.18
United Facility/Professional Professional Modifier Low / Median / High Price $315.04 / $526.40 / $921.84	Professional		$315.04	$526.40	$921.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.99 / $100.22 / $212.55	Professional	26	$95.99	$100.22	$212.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $215.34 / $372.06 / $770.04	Professional	TC	$215.34	$372.06	$770.04