Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $229.09 / $575.44	Facility		$28.18	$229.09	$575.44
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $29.51 / $40.74	Facility	26	$9.55	$29.51	$40.74
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.54 / $53.70 / $128.82	Facility	TC	$27.54	$53.70	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $38.02 / $104.71	Professional		$22.91	$38.02	$104.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.96 / $32.36	Professional	26	$7.08	$10.96	$32.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $22.39 / $63.10	Professional	TC	$15.14	$22.39	$63.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $25.12 / $42.66	Professional		$18.20	$25.12	$42.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $6.76 / $14.13	Professional	26	$6.17	$6.76	$14.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $15.14 / $19.95	Professional	TC	$12.59	$15.14	$19.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $54.95 / $107.15	Facility		$13.49	$54.95	$107.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $26.30 / $48.98	Professional		$21.38	$26.30	$48.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $7.41 / $13.18	Professional	26	$5.75	$7.41	$13.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $19.05 / $35.48	Professional	TC	$15.49	$19.05	$35.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $85.11 / $331.13	Facility		$26.92	$85.11	$331.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $4.57 / $21.38 / $30.20	Facility	TC	$4.57	$21.38	$30.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $33.88 / $60.26	Professional		$23.44	$33.88	$60.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.00 / $18.62	Professional	26	$7.08	$10.00	$18.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $22.91 / $43.65	Professional	TC	$15.85	$22.91	$43.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $34.67 / $93.33	Facility		$25.12	$34.67	$93.33
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $19.50 / $100.00 / $100.00	Facility	26	$19.50	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $41.69 / $100.00 / $100.00	Facility	TC	$41.69	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $31.62 / $177.83	Professional		$25.70	$31.62	$177.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $9.55 / $77.62	Professional	26	$8.13	$9.55	$77.62
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $22.91 / $162.18	Professional	TC	$16.98	$22.91	$162.18
United Facility/Professional Facility Modifier Low / Median / High Price $9.77 / $91.20 / $134.90	Facility		$9.77	$91.20	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $28.84 / $42.66	Professional		$25.12	$28.84	$42.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.12 / $13.80	Professional	26	$7.94	$9.12	$13.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $19.95 / $29.51	Professional	TC	$16.98	$19.95	$29.51