Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.64 / $96.45 / $505.89	Facility		$36.64	$96.45	$505.89
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.34 / $15.54 / $32.57	Facility	26	$8.34	$15.54	$32.57
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $35.08 / $49.22 / $141.93	Facility	TC	$35.08	$49.22	$141.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.79 / $37.96 / $116.52	Professional		$25.79	$37.96	$116.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.90 / $8.46 / $37.96	Professional	26	$6.90	$8.46	$37.96
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.88 / $52.88 / $52.88	Professional	50	$52.88	$52.88	$52.88
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.22 / $15.36 / $94.43	Professional	52	$11.22	$15.36	$94.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $23.69 / $51.62	Professional	TC	$19.14	$23.69	$51.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.92 / $29.35 / $34.11	Professional		$24.92	$29.35	$34.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.13 / $10.44 / $14.11	Professional	26	$6.13	$10.44	$14.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $18.82 / $18.82	Professional	TC	$18.82	$18.82	$18.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $19.30 / $70.14 / $116.09	Facility		$19.30	$70.14	$116.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.74 / $29.42 / $36.77	Professional		$25.74	$29.42	$36.77
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.57 / $6.37 / $7.96	Professional	26	$5.57	$6.37	$7.96
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.17 / $23.05 / $28.81	Professional	TC	$20.17	$23.05	$28.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.83 / $189.46 / $247.64	Facility		$60.83	$189.46	$247.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.19 / $36.03 / $62.98	Professional		$26.19	$36.03	$62.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.80 / $9.92 / $17.57	Professional	26	$6.80	$9.92	$17.57
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $41.47 / $41.47 / $41.47	Professional	50	$41.47	$41.47	$41.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.02 / $26.79 / $45.87	Professional	TC	$19.02	$26.79	$45.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.18 / $38.26 / $91.28	Facility		$30.18	$38.26	$91.28
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $116.58 / $116.58 / $116.58	Facility	TC	$116.58	$116.58	$116.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.72 / $33.20 / $217.55	Professional		$27.72	$33.20	$217.55
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.58 / $9.18 / $59.45	Professional	26	$7.58	$9.18	$59.45
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.47 / $24.54 / $166.53	Professional	TC	$19.47	$24.54	$166.53
United Facility/Professional Professional Modifier Low / Median / High Price $26.64 / $33.20 / $53.12	Professional		$26.64	$33.20	$53.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.58 / $8.80 / $15.88	Professional	26	$7.58	$8.80	$15.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.43 / $24.54 / $41.61	Professional	TC	$19.43	$24.54	$41.61