Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.52 / $155.34 / $198.15	Facility	26	$118.52	$155.34	$198.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $425.00 / $560.74	Professional		$250.00	$425.00	$560.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $136.90 / $181.06	Professional	26	$62.50	$136.90	$181.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $261.75 / $379.67	Professional	TC	$187.50	$261.75	$379.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.60 / $117.60 / $483.62	Professional		$117.60	$117.60	$483.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.13 / $83.58 / $136.90	Professional	26	$81.13	$83.58	$136.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.85 / $332.50 / $456.57	Professional		$108.85	$332.50	$456.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.80 / $117.80 / $189.75	Facility	26	$117.80	$117.80	$189.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $276.85 / $544.45 / $989.14	Professional		$276.85	$544.45	$989.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.34 / $117.80 / $185.14	Professional	26	$96.34	$117.80	$185.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $179.49 / $364.29 / $772.55	Professional	TC	$179.49	$364.29	$772.55
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $794.00 / $1,016.96 / $1,016.96	Facility	26	$794.00	$1,016.96	$1,016.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $324.97 / $501.75 / $6,199.75	Professional		$324.97	$501.75	$6,199.75
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $102.04 / $129.02 / $931.20	Professional	26	$102.04	$129.02	$931.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $222.93 / $439.10 / $5,551.18	Professional	TC	$222.93	$439.10	$5,551.18
United Facility/Professional Professional Modifier Low / Median / High Price $324.97 / $410.88 / $1,094.34	Professional		$324.97	$410.88	$1,094.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.04 / $117.29 / $219.09	Professional	26	$102.04	$117.29	$219.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $222.93 / $263.93 / $883.73	Professional	TC	$222.93	$263.93	$883.73