Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.55 / $165.47 / $196.97	Facility	26	$108.55	$165.47	$196.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $460.00 / $557.79	Professional		$250.00	$460.00	$557.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $140.00 / $181.06	Professional	26	$62.50	$140.00	$181.06
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $125.00 / $175.87 / $278.89	Professional	52	$125.00	$175.87	$278.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $335.00 / $376.74	Professional	TC	$187.50	$335.00	$376.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.48 / $322.83 / $359.40	Professional		$234.48	$322.83	$359.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.90 / $100.13 / $171.38	Professional	26	$80.90	$100.13	$171.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $215.64 / $215.64 / $242.31	Professional	TC	$215.64	$215.64	$242.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.37 / $329.35 / $452.24	Professional		$115.37	$329.35	$452.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.35 / $108.35 / $174.20	Facility	26	$108.35	$108.35	$174.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $276.02 / $540.36 / $978.49	Professional		$276.02	$540.36	$978.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.07 / $109.47 / $181.23	Professional	26	$96.07	$109.47	$181.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $178.94 / $367.50 / $783.20	Professional	TC	$178.94	$367.50	$783.20
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 $322.45 / $489.50 / $6,146.58	Professional		$322.45	$489.50	$6,146.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $95.99 / $118.57 / $921.60	Professional	26	$95.99	$118.57	$921.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $220.41 / $466.52 / $5,551.18	Professional	TC	$220.41	$466.52	$5,551.18
United Facility/Professional Professional Modifier Low / Median / High Price $322.45 / $400.54 / $1,090.91	Professional		$322.45	$400.54	$1,090.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.99 / $117.29 / $224.73	Professional	26	$95.99	$117.29	$224.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $220.41 / $278.68 / $890.90	Professional	TC	$220.41	$278.68	$890.90