Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.86 / $188.15 / $378.88	Facility		$39.86	$188.15	$378.88
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.07 / $9.77 / $14.91	Facility	26	$8.07	$9.77	$14.91
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.03 / $42.88 / $264.70	Facility	TC	$29.03	$42.88	$264.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.44 / $32.54 / $40.20	Professional		$22.44	$32.54	$40.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.66 / $9.14 / $13.98	Professional	26	$7.66	$9.14	$13.98
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.64 / $16.57 / $19.42	Professional	52	$14.64	$16.57	$19.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.07 / $25.16 / $33.72	Professional	TC	$20.07	$25.16	$33.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.88 / $55.22 / $55.22	Professional		$23.88	$55.22	$55.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.92 / $5.95 / $9.25	Professional	26	$5.92	$5.95	$9.25
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.07 / $29.19 / $41.53	Professional	TC	$19.07	$29.19	$41.53
BCBS Facility/Professional Facility Modifier Low / Median / High Price $70.67 / $96.64 / $520.77	Facility		$70.67	$96.64	$520.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.64 / $45.64 / $45.64	Professional		$45.64	$45.64	$45.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.54 / $112.50 / $241.75	Facility		$45.54	$112.50	$241.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.75 / $42.14 / $60.28	Professional		$23.75	$42.14	$60.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.21 / $12.08 / $15.00	Professional	26	$7.21	$12.08	$15.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.72 / $30.05 / $50.27	Professional	TC	$16.72	$30.05	$50.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $32.15 / $38.84 / $65.98	Facility		$32.15	$38.84	$65.98
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $18.72 / $18.72 / $100.00	Facility	26	$18.72	$18.72	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $54.35 / $116.58 / $364.90	Facility	TC	$54.35	$116.58	$364.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.39 / $36.52 / $217.55	Professional		$27.39	$36.52	$217.55
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.57 / $10.26 / $59.45	Professional	26	$7.57	$10.26	$59.45
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.82 / $26.99 / $166.53	Professional	TC	$19.82	$26.99	$166.53
United Facility/Professional Professional Modifier Low / Median / High Price $27.39 / $33.04 / $53.12	Professional		$27.39	$33.04	$53.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.57 / $9.24 / $14.53	Professional	26	$7.57	$9.24	$14.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.82 / $24.24 / $41.72	Professional	TC	$19.82	$24.24	$41.72