Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.73 / $107.10 / $464.54	Facility		$25.73	$107.10	$464.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.42 / $8.52 / $12.56	Facility	26	$6.42	$8.52	$12.56
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.21 / $26.60 / $198.42	Facility	TC	$19.21	$26.60	$198.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.53 / $31.00 / $34.17	Professional		$21.53	$31.00	$34.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.45 / $7.72 / $9.07	Professional	26	$5.45	$7.72	$9.07
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.77 / $15.75 / $17.09	Professional	52	$10.77	$15.75	$17.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.09 / $22.76 / $25.97	Professional	TC	$16.09	$22.76	$25.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.62 / $29.62 / $45.09	Professional		$29.62	$29.62	$45.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.96 / $7.66 / $12.61	Professional	26	$5.96	$7.66	$12.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.60 / $26.60 / $26.60	Professional	TC	$26.60	$26.60	$26.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $52.11 / $69.98 / $101.39	Facility		$52.11	$69.98	$101.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.22 / $31.15 / $42.77	Professional		$8.22	$31.15	$42.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.96 / $28.45 / $43.14	Facility		$25.96	$28.45	$43.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.44 / $7.44 / $11.74	Facility	26	$7.44	$7.44	$11.74
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $15.57 / $15.57 / $24.22	Facility	TC	$15.57	$15.57	$24.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.60 / $28.56 / $45.09	Professional		$23.60	$28.56	$45.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $7.91 / $13.22	Professional	26	$7.08	$7.91	$13.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.94 / $20.65 / $32.20	Professional	TC	$15.94	$20.65	$32.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.42 / $37.04 / $68.28	Facility		$25.42	$37.04	$68.28
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $18.72 / $100.00 / $100.00	Facility	26	$18.72	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $54.35 / $116.58 / $116.58	Facility	TC	$54.35	$116.58	$116.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.06 / $33.88 / $217.55	Professional		$27.06	$33.88	$217.55
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.53 / $8.68 / $59.45	Professional	26	$7.53	$8.68	$59.45
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $18.64 / $23.31 / $166.53	Professional	TC	$18.64	$23.31	$166.53
United Facility/Professional Professional Modifier Low / Median / High Price $25.76 / $30.88 / $50.17	Professional		$25.76	$30.88	$50.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $8.23 / $13.86	Professional	26	$7.36	$8.23	$13.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.39 / $22.80 / $38.72	Professional	TC	$18.39	$22.80	$38.72