Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $109.65 / $128.82	Facility	26	$79.43	$109.65	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $316.23 / $501.19	Professional		$194.98	$316.23	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $109.65 / $199.53	Professional	26	$64.57	$109.65	$199.53
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $199.53 / $199.53 / $199.53	Professional	52	$199.53	$199.53	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $204.17 / $380.19	Professional	TC	$123.03	$204.17	$380.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $147.91 / $229.09	Professional		$128.82	$147.91	$229.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $64.57 / $112.20	Professional	26	$52.48	$64.57	$112.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $93.33 / $177.83	Professional	TC	$79.43	$93.33	$177.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $194.98 / $269.15	Professional		$70.79	$194.98	$269.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $117.49	Facility	26	$72.44	$72.44	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $371.54 / $575.44	Professional		$177.83	$371.54	$575.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $77.62 / $144.54	Professional	26	$61.66	$77.62	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $288.40 / $467.74	Professional	TC	$114.82	$288.40	$467.74
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 $190.55 / $288.40 / $2,884.03	Professional		$190.55	$288.40	$2,884.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $83.18 / $562.34	Professional	26	$64.57	$83.18	$562.34
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $263.03 / $2,511.89	Professional	TC	$125.89	$263.03	$2,511.89
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $239.88 / $645.65	Professional		$186.21	$239.88	$645.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $75.86 / $117.49	Professional	26	$64.57	$75.86	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $151.36 / $537.03	Professional	TC	$123.03	$151.36	$537.03