Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.57 / $159.80 / $667.55	Facility		$29.57	$159.80	$667.55
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.05 / $16.86 / $32.61	Facility	26	$9.05	$16.86	$32.61
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.28 / $61.87 / $332.28	Facility	TC	$22.28	$61.87	$332.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.41 / $22.59 / $83.20	Professional		$17.41	$22.59	$83.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $9.78 / $37.11	Professional	26	$7.78	$9.78	$37.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.69 / $14.06 / $31.55	Professional	TC	$9.69	$14.06	$31.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.94 / $22.70 / $26.02	Professional		$17.94	$22.70	$26.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.65 / $10.05 / $20.00	Professional	26	$6.65	$10.05	$20.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $13.47 / $56.98 / $84.77	Facility		$13.47	$56.98	$84.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.43 / $23.34 / $29.18	Professional		$20.43	$23.34	$29.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.82 / $7.79 / $10.97	Professional	26	$6.82	$7.79	$10.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.61 / $15.55 / $19.44	Professional	TC	$13.61	$15.55	$19.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $150.53 / $214.77 / $247.64	Facility		$150.53	$214.77	$247.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $19.39 / $19.39 / $19.39	Facility	TC	$19.39	$19.39	$19.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.19 / $25.81 / $45.22	Professional		$19.19	$25.81	$45.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.37 / $10.95 / $17.97	Professional	26	$7.37	$10.95	$17.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.57 / $14.99 / $30.15	Professional	TC	$10.57	$14.99	$30.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $23.63 / $32.07 / $167.53	Facility		$23.63	$32.07	$167.53
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $20.47 / $70.00 / $70.00	Facility	26	$20.47	$70.00	$70.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $36.54 / $78.72 / $78.72	Facility	TC	$36.54	$78.72	$78.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $25.98 / $165.42	Professional		$19.05	$25.98	$165.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.84 / $9.86 / $55.28	Professional	26	$8.84	$9.86	$55.28
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $10.21 / $16.60 / $110.07	Professional	TC	$10.21	$16.60	$110.07
United Facility/Professional Facility Modifier Low / Median / High Price $80.90 / $80.90 / $195.48	Facility		$80.90	$80.90	$195.48
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $25.98 / $47.64	Professional		$19.05	$25.98	$47.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.83 / $9.38 / $17.20	Professional	26	$8.83	$9.38	$17.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.21 / $16.55 / $24.37	Professional	TC	$10.21	$16.55	$24.37