Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.91 / $79.36 / $116.72	Facility	26	$65.91	$79.36	$116.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.40 / $172.96 / $213.88	Professional		$134.40	$172.96	$213.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.28 / $63.36 / $98.84	Professional	26	$48.28	$63.36	$98.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.29 / $109.60 / $156.84	Professional	TC	$88.29	$109.60	$156.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.20 / $100.20 / $120.30	Professional		$100.20	$100.20	$120.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.79 / $37.88 / $54.33	Professional	26	$37.79	$37.88	$54.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $62.41 / $66.31 / $101.41	Professional	TC	$62.41	$66.31	$101.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $219.59 / $219.59 / $219.59	Professional		$219.59	$219.59	$219.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.01 / $200.32 / $264.62	Professional		$121.01	$200.32	$264.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.32 / $67.40 / $95.13	Professional	26	$42.32	$67.40	$95.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.25 / $122.80 / $169.49	Professional	TC	$77.25	$122.80	$169.49
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $371.04 / $479.84 / $479.84	Facility	26	$371.04	$479.84	$479.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $153.91 / $194.77 / $915.52	Professional		$153.91	$194.77	$915.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $54.20 / $68.05 / $323.73	Professional	26	$54.20	$68.05	$323.73
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $99.72 / $126.72 / $591.79	Professional	TC	$99.72	$126.72	$591.79
United Facility/Professional Professional Modifier Low / Median / High Price $153.91 / $173.88 / $268.72	Professional		$153.91	$173.88	$268.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.90 / $62.33 / $95.72	Professional	26	$53.90	$62.33	$95.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $99.72 / $119.21 / $195.84	Professional	TC	$99.72	$119.21	$195.84