Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.86 / $226.00 / $269.16	Facility	26	$141.86	$226.00	$269.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $419.35 / $527.69 / $796.50	Professional		$419.35	$527.69	$796.50
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $521.33 / $521.33 / $525.78	Professional	22	$521.33	$521.33	$525.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $177.46 / $269.16	Professional	26	$140.00	$177.46	$269.16
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $204.93 / $263.85 / $398.25	Professional	52	$204.93	$263.85	$398.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $303.49 / $355.51 / $557.00	Professional	TC	$303.49	$355.51	$557.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $231.70 / $231.70 / $498.02	Professional		$231.70	$231.70	$498.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.30 / $80.76 / $115.44	Professional	26	$80.30	$80.76	$115.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $151.40 / $246.03 / $246.03	Professional	TC	$151.40	$246.03	$246.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $600.00 / $600.00 / $600.00	Professional		$600.00	$600.00	$600.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.80 / $575.00 / $1,624.00	Professional		$267.80	$575.00	$1,624.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $94.31 / $158.60 / $204.69	Professional	26	$94.31	$158.60	$204.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $197.58 / $401.00 / $1,429.00	Professional	TC	$197.58	$401.00	$1,429.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $791.52 / $1,013.76 / $1,013.76	Facility	26	$791.52	$1,013.76	$1,013.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $380.90 / $889.40 / $6,146.58	Professional		$380.90	$889.40	$6,146.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $106.88 / $158.38 / $921.60	Professional	26	$106.88	$158.38	$921.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $259.50 / $782.52 / $5,551.18	Professional	TC	$259.50	$782.52	$5,551.18
United Facility/Professional Professional Modifier Low / Median / High Price $370.64 / $630.09 / $1,247.29	Professional		$370.64	$630.09	$1,247.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $106.88 / $129.02 / $222.64	Professional	26	$106.88	$129.02	$222.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $253.35 / $426.85 / $987.17	Professional	TC	$253.35	$426.85	$987.17