Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $245.47 / $338.84	Facility	26	$125.89	$245.47	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $467.74 / $1,412.54	Professional		$204.17	$467.74	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $128.82 / $288.40	Professional	26	$67.61	$128.82	$288.40
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $123.03 / $512.86 / $549.54	Professional	52	$123.03	$512.86	$549.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $251.19 / $691.83	Professional	TC	$123.03	$251.19	$691.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $181.97 / $316.23	Professional		$125.89	$181.97	$316.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $64.57 / $117.49	Professional	26	$52.48	$64.57	$117.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $104.71 / $204.17	Professional	TC	$81.28	$104.71	$204.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $245.47 / $436.52	Professional		$190.55	$245.47	$436.52
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $75.86 / $138.04	Professional	26	$61.66	$75.86	$138.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $165.96 / $295.12	Professional	TC	$128.82	$165.96	$295.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $114.82	Facility	26	$16.98	$79.43	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $371.54 / $660.69	Professional		$158.49	$371.54	$660.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $87.10 / $158.49	Professional	26	$53.70	$87.10	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $263.03 / $512.86	Professional	TC	$104.71	$263.03	$512.86
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $512.86 / $660.69 / $660.69	Facility	26	$512.86	$660.69	$660.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $407.38 / $2,884.03	Professional		$186.21	$407.38	$2,884.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $77.62 / $562.34	Professional	26	$64.57	$77.62	$562.34
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $309.03 / $2,511.89	Professional	TC	$123.03	$309.03	$2,511.89
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $331.13 / $524.81	Professional		$186.21	$331.13	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $67.61 / $123.03	Professional	26	$64.57	$67.61	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $234.42 / $436.52	Professional	TC	$123.03	$234.42	$436.52