Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $204.17 / $275.42	Facility	26	$112.20	$204.17	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $275.42 / $660.69	Professional		$169.82	$275.42	$660.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $85.11 / $218.78	Professional	26	$52.48	$85.11	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $186.21 / $436.52	Professional	TC	$112.20	$186.21	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $295.12	Professional		$147.91	$147.91	$295.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $44.67 / $95.50	Professional	26	$42.66	$44.67	$95.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $58.88 / $58.88	Professional	TC	$58.88	$58.88	$58.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $218.78 / $389.05	Professional		$169.82	$218.78	$389.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $64.57 / $114.82	Professional	26	$50.12	$64.57	$114.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $154.88 / $269.15	Professional	TC	$120.23	$154.88	$269.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $66.07 / $93.33	Facility	26	$14.13	$66.07	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $263.03 / $501.19	Professional		$141.25	$263.03	$501.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $67.61 / $123.03	Professional	26	$43.65	$67.61	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $186.21 / $380.19	Professional	TC	$97.72	$186.21	$380.19
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $416.87 / $537.03 / $537.03	Facility	26	$416.87	$537.03	$537.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $288.40 / $1,862.09	Professional		$169.82	$288.40	$1,862.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $60.26 / $436.52	Professional	26	$48.98	$60.26	$436.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $239.88 / $1,584.89	Professional	TC	$114.82	$239.88	$1,584.89
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $251.19 / $407.38	Professional		$169.82	$251.19	$407.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $52.48 / $97.72	Professional	26	$48.98	$52.48	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $194.98 / $295.12	Professional	TC	$114.82	$194.98	$295.12