Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.72 / $132.52 / $178.80	Facility	26	$110.72	$132.52	$178.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.45 / $391.84 / $462.24	Professional		$257.45	$391.84	$462.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.98 / $106.43 / $170.00	Professional	26	$82.98	$106.43	$170.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $163.94 / $259.32 / $350.77	Professional	TC	$163.94	$259.32	$350.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.59 / $231.28 / $445.46	Professional		$204.59	$231.28	$445.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.73 / $64.06 / $91.62	Professional	26	$63.73	$64.06	$91.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $209.46 / $209.46 / $209.46	Professional	TC	$209.46	$209.46	$209.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $484.14 / $484.14 / $484.14	Professional		$484.14	$484.14	$484.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.89 / $448.62 / $858.00	Professional		$235.89	$448.62	$858.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.59 / $113.13 / $162.72	Professional	26	$75.59	$113.13	$162.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $174.41 / $316.52 / $699.00	Professional	TC	$174.41	$316.52	$699.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $627.76 / $804.96 / $804.96	Facility	26	$627.76	$804.96	$804.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $318.27 / $513.54 / $3,183.14	Professional		$318.27	$513.54	$3,183.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.53 / $127.04 / $1,009.00	Professional	26	$87.53	$127.04	$1,009.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $219.95 / $422.42 / $2,699.58	Professional	TC	$219.95	$422.42	$2,699.58
United Facility/Professional Professional Modifier Low / Median / High Price $307.83 / $473.55 / $682.46	Professional		$307.83	$473.55	$682.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.53 / $101.86 / $163.85	Professional	26	$87.53	$101.86	$163.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $219.95 / $365.04 / $550.69	Professional	TC	$219.95	$365.04	$550.69