Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $229.09 / $501.19	Facility		$41.69	$229.09	$501.19
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.71 / $10.00 / $18.62	Facility	26	$8.71	$10.00	$18.62
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.54 / $85.11 / $309.03	Facility	TC	$27.54	$85.11	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $32.36 / $75.86	Professional		$11.22	$32.36	$75.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.96 / $28.84	Professional	26	$7.08	$10.96	$28.84
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $151.36 / $186.21	Professional	50	$42.66	$151.36	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $27.54 / $56.23	Professional	TC	$19.95	$27.54	$56.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $25.12 / $40.74	Professional		$20.42	$25.12	$40.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $7.41 / $13.18	Professional	26	$6.17	$7.41	$13.18
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $30.20 / $30.20 / $36.31	Professional	50	$30.20	$30.20	$36.31
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $23.44 / $29.51	Professional	TC	$15.49	$23.44	$29.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $144.54 / $199.53	Facility		$114.82	$144.54	$199.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Professional		$48.98	$48.98	$48.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $107.15 / $194.98	Facility		$74.13	$107.15	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $40.74 / $63.10	Professional		$22.91	$40.74	$63.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.96 / $18.20	Professional	26	$7.08	$10.96	$18.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $31.62 / $47.86	Professional	TC	$17.78	$31.62	$47.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $44.67 / $85.11	Facility		$32.36	$44.67	$85.11
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $19.50 / $19.50 / $100.00	Facility	26	$19.50	$19.50	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $51.29 / $51.29 / $109.65	Facility	TC	$51.29	$51.29	$109.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $38.90 / $208.93	Professional		$30.20	$38.90	$208.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.72 / $74.13	Professional	26	$8.32	$10.72	$74.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $27.54 / $177.83	Professional	TC	$21.38	$27.54	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $66.07 / $97.72	Facility		$21.88	$66.07	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $34.67 / $51.29	Professional		$29.51	$34.67	$51.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $9.12 / $14.45	Professional	26	$8.32	$9.12	$14.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $24.55 / $38.02	Professional	TC	$21.38	$24.55	$38.02