Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.31 / $67.31 / $74.05	Facility	26	$67.31	$67.31	$74.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.38 / $170.19 / $181.99	Professional		$138.38	$170.19	$181.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.28 / $54.53 / $68.84	Professional	26	$48.28	$54.53	$68.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $86.37 / $108.79 / $119.70	Professional	TC	$86.37	$108.79	$119.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $124.39 / $124.39 / $139.38	Professional		$124.39	$124.39	$139.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.99 / $47.12 / $80.65	Professional	26	$37.99	$47.12	$80.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $99.97 / $99.97 / $153.93	Professional	TC	$99.97	$99.97	$153.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.66 / $137.55 / $188.88	Professional		$53.66	$137.55	$188.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.41 / $81.41 / $81.41	Facility	26	$81.41	$81.41	$81.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $136.78 / $228.06	Professional		$117.49	$136.78	$228.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $50.36 / $84.82	Professional	26	$42.60	$50.36	$84.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.06 / $85.05 / $143.24	Professional	TC	$73.06	$85.05	$143.24
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 $134.36 / $158.07 / $915.52	Professional		$134.36	$158.07	$915.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $46.33 / $54.50 / $323.73	Professional	26	$46.33	$54.50	$323.73
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $88.03 / $103.57 / $591.79	Professional	TC	$88.03	$103.57	$591.79
United Facility/Professional Professional Modifier Low / Median / High Price $134.36 / $157.85 / $262.80	Professional		$134.36	$157.85	$262.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.33 / $54.50 / $82.54	Professional	26	$46.33	$54.50	$82.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.96 / $103.57 / $157.75	Professional	TC	$85.96	$103.57	$157.75