Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $251.19 / $707.95	Facility		$48.98	$251.19	$707.95
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.24 / $8.13 / $14.13	Facility	26	$7.24	$8.13	$14.13
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.05 / $100.00 / $467.74	Facility	TC	$19.05	$100.00	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $31.62 / $67.61	Professional		$8.91	$31.62	$67.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.00 / $40.74	Professional	26	$7.08	$10.00	$40.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $29.51 / $70.79 / $165.96	Professional	50	$29.51	$70.79	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $25.70 / $61.66	Professional	TC	$18.62	$25.70	$61.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $27.54 / $44.67	Professional		$21.38	$27.54	$44.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $8.71 / $14.13	Professional	26	$6.76	$8.71	$14.13
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $33.11 / $40.74 / $69.18	Professional	50	$33.11	$40.74	$69.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $26.30 / $38.02	Professional	TC	$16.98	$26.30	$38.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $75.86 / $102.33	Facility		$50.12	$75.86	$102.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $31.62 / $43.65	Professional		$9.12	$31.62	$43.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $112.20	Facility		$25.70	$25.70	$112.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $8.51 / $13.49	Facility	26	$8.51	$8.51	$13.49
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $15.85 / $15.85 / $28.84	Facility	TC	$15.85	$15.85	$28.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $30.90 / $54.95	Professional		$23.44	$30.90	$54.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.33 / $15.85	Professional	26	$7.76	$9.33	$15.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $21.38 / $36.31	Professional	TC	$15.49	$21.38	$36.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $45.71 / $269.15	Facility		$26.30	$45.71	$269.15
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $100.00 / $100.00	Facility	26	$20.89	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $104.71 / $117.49 / $194.98	Facility	TC	$104.71	$117.49	$194.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $36.31 / $223.87	Professional		$27.54	$36.31	$223.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.00 / $89.13	Professional	26	$8.32	$10.00	$89.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $23.99 / $177.83	Professional	TC	$17.78	$23.99	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $67.61 / $213.80	Facility		$19.05	$67.61	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $31.62 / $47.86	Professional		$26.30	$31.62	$47.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $9.33 / $14.45	Professional	26	$8.13	$9.33	$14.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $22.39 / $32.36	Professional	TC	$17.78	$22.39	$32.36