Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.49 / $157.50 / $281.43	Facility	26	$97.49	$157.50	$281.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $260.45 / $475.00 / $963.49	Professional		$260.45	$475.00	$963.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.05 / $140.00 / $264.06	Professional	26	$73.05	$140.00	$264.06
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $122.06 / $187.50 / $237.50	Professional	52	$122.06	$187.50	$237.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $188.15 / $335.00 / $441.00	Professional	TC	$188.15	$335.00	$441.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.80 / $202.12 / $645.28	Professional		$158.80	$202.12	$645.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.33 / $92.22 / $122.17	Professional	26	$53.33	$92.22	$122.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $230.27 / $263.17 / $328.96	Professional		$230.27	$263.17	$328.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.19 / $68.79 / $85.99	Professional	26	$60.19	$68.79	$85.99
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $170.08 / $194.38 / $242.97	Professional	TC	$170.08	$194.38	$242.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.45 / $79.45 / $79.45	Facility	26	$79.45	$79.45	$79.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $464.00 / $760.47	Professional		$199.53	$464.00	$760.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.64 / $86.30 / $148.58	Professional	26	$50.64	$86.30	$148.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.02 / $350.62 / $629.76	Professional	TC	$141.02	$350.62	$629.76
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $650.32 / $650.32 / $650.32	Facility	26	$650.32	$650.32	$650.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $229.76 / $478.64 / $3,507.01	Professional		$229.76	$478.64	$3,507.01
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $59.27 / $70.95 / $571.29	Professional	26	$59.27	$70.95	$571.29
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $165.95 / $415.39 / $2,477.29	Professional	TC	$165.95	$415.39	$2,477.29
United Facility/Professional Professional Modifier Low / Median / High Price $229.76 / $409.67 / $603.36	Professional		$229.76	$409.67	$603.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.27 / $64.25 / $141.25	Professional	26	$59.27	$64.25	$141.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.95 / $340.50 / $468.72	Professional	TC	$165.95	$340.50	$468.72