Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.28 / $146.44 / $174.34	Facility	26	$89.28	$146.44	$174.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $272.50 / $410.23 / $494.18	Professional		$272.50	$410.23	$494.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.28 / $140.00 / $175.72	Professional	26	$89.28	$140.00	$175.72
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $136.25 / $159.61 / $238.68	Professional	52	$136.25	$159.61	$238.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $174.33 / $260.39 / $442.43	Professional	TC	$174.33	$260.39	$442.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.19 / $144.87 / $298.77	Professional		$139.19	$144.87	$298.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.94 / $52.07 / $74.66	Professional	26	$51.94	$52.07	$74.66
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $87.26 / $141.79 / $141.79	Professional	TC	$87.26	$141.79	$141.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $450.28 / $450.28 / $450.28	Professional		$450.28	$450.28	$450.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.05 / $350.38 / $897.00	Professional		$161.05	$350.38	$897.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.79 / $100.28 / $183.00	Professional	26	$59.79	$100.28	$183.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $113.50 / $230.19 / $714.00	Professional	TC	$113.50	$230.19	$714.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $510.16 / $659.84 / $659.84	Facility	26	$510.16	$659.84	$659.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $228.64 / $514.74 / $3,145.84	Professional		$228.64	$514.74	$3,145.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $67.09 / $99.71 / $577.89	Professional	26	$67.09	$99.71	$577.89
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $148.24 / $447.65 / $2,772.01	Professional	TC	$148.24	$447.65	$2,772.01
United Facility/Professional Professional Modifier Low / Median / High Price $220.87 / $353.39 / $640.95	Professional		$220.87	$353.39	$640.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.09 / $83.77 / $144.54	Professional	26	$67.09	$83.77	$144.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.72 / $240.08 / $520.22	Professional	TC	$144.72	$240.08	$520.22