Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $302.00 / $416.87	Facility	26	$114.82	$302.00	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $389.05 / $1,548.82	Professional		$239.88	$389.05	$1,548.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $93.33 / $302.00	Professional	26	$77.62	$93.33	$302.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $239.88 / $602.56	Professional	TC	$162.18	$239.88	$602.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $269.15 / $489.78	Professional		$204.17	$269.15	$489.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $79.43 / $134.90	Professional	26	$63.10	$79.43	$134.90
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $177.83 / $288.40	Professional	TC	$158.49	$177.83	$288.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $346.74 / $602.56	Professional		$269.15	$346.74	$602.56
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $93.33 / $169.82	Professional	26	$75.86	$93.33	$169.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $245.47 / $436.52	Professional	TC	$190.55	$245.47	$436.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $141.25	Facility	26	$20.89	$97.72	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $407.38 / $776.25	Professional		$234.42	$407.38	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $102.33 / $190.55	Professional	26	$64.57	$102.33	$190.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $281.84 / $588.84	Professional	TC	$169.82	$281.84	$588.84
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $630.96 / $812.83 / $812.83	Facility	26	$630.96	$812.83	$812.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $436.52 / $3,162.28	Professional		$257.04	$436.52	$3,162.28
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $102.33 / $1,000.00	Professional	26	$79.43	$102.33	$1,000.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $354.81 / $2,691.53	Professional	TC	$177.83	$354.81	$2,691.53
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $380.19 / $645.65	Professional		$257.04	$380.19	$645.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $83.18 / $147.91	Professional	26	$79.43	$83.18	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $302.00 / $478.63	Professional	TC	$177.83	$302.00	$478.63