Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $269.15 / $389.05	Facility		$25.12	$269.15	$389.05
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $10.96 / $16.60	Facility	26	$7.08	$10.96	$16.60
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.38 / $63.10 / $323.59	Facility	TC	$17.38	$63.10	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $33.11 / $75.86	Professional		$23.99	$33.11	$75.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.00 / $26.30	Professional	26	$7.94	$10.00	$26.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $22.91 / $41.69	Professional	TC	$16.98	$22.91	$41.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $25.12 / $41.69	Professional		$20.89	$25.12	$41.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $9.77 / $15.85	Professional	26	$7.41	$9.77	$15.85
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $21.88 / $33.88	Professional	TC	$17.38	$21.88	$33.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $75.86 / $102.33	Facility		$51.29	$75.86	$102.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $30.20 / $41.69	Professional		$9.77	$30.20	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $23.44 / $138.04	Facility		$23.44	$23.44	$138.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $10.00 / $16.22	Facility	26	$10.00	$10.00	$16.22
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $17.78 / $17.78 / $32.36	Facility	TC	$17.78	$17.78	$32.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $33.11 / $54.95	Professional		$25.12	$33.11	$54.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $10.72 / $18.20	Professional	26	$8.51	$10.72	$18.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $20.89 / $37.15	Professional	TC	$16.60	$20.89	$37.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $45.71 / $251.19	Facility		$25.12	$45.71	$251.19
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $100.00 / $100.00	Facility	26	$22.91	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $48.98 / $107.15 / $107.15	Facility	TC	$48.98	$107.15	$107.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $37.15 / $218.78	Professional		$27.54	$37.15	$218.78
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $11.22 / $87.10	Professional	26	$9.12	$11.22	$87.10
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $24.55 / $204.17	Professional	TC	$17.78	$24.55	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $81.28 / $257.04	Facility		$20.89	$81.28	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $32.36 / $50.12	Professional		$26.92	$32.36	$50.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $10.23 / $15.85	Professional	26	$8.91	$10.23	$15.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $21.38 / $34.67	Professional	TC	$17.38	$21.38	$34.67