Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.20 / $250.87 / $606.32	Facility		$44.20	$250.87	$606.32
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.69 / $16.19 / $39.15	Facility	26	$8.69	$16.19	$39.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $42.48 / $147.24 / $345.68	Facility	TC	$42.48	$147.24	$345.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.40 / $50.85 / $162.00	Professional		$30.40	$50.85	$162.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.28 / $9.57 / $38.92	Professional	26	$7.28	$9.57	$38.92
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.85 / $249.48 / $299.48	Professional	50	$17.85	$249.48	$299.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.37 / $33.99 / $97.26	Professional	TC	$25.37	$33.99	$97.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.39 / $36.04 / $42.06	Professional		$28.39	$36.04	$42.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.35 / $7.98 / $11.51	Professional	26	$6.35	$7.98	$11.51
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $45.84 / $45.84 / $45.84	Professional	50	$45.84	$45.84	$45.84
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.39 / $24.21 / $31.18	Professional	TC	$23.39	$24.21	$31.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $84.77 / $142.27	Facility		$25.12	$84.77	$142.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.75 / $36.28 / $45.35	Professional		$31.75	$36.28	$45.35
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.80 / $6.63 / $9.31	Professional	26	$5.80	$6.63	$9.31
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.94 / $29.65 / $37.06	Professional	TC	$25.94	$29.65	$37.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $76.30 / $189.46 / $247.64	Facility		$76.30	$189.46	$247.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $36.90 / $36.90 / $36.90	Facility	TC	$36.90	$36.90	$36.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.64 / $42.93 / $74.05	Professional		$30.64	$42.93	$74.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.29 / $17.95	Professional	26	$7.08	$10.29	$17.95
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.36 / $47.36 / $47.36	Professional	50	$47.36	$47.36	$47.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.69 / $32.09 / $56.26	Professional	TC	$22.69	$32.09	$56.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $34.94 / $46.96 / $291.39	Facility		$34.94	$46.96	$291.39
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 $149.85 / $149.85 / $149.85	Facility	TC	$149.85	$149.85	$149.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.20 / $39.34 / $263.06	Professional		$32.20	$39.34	$263.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.15 / $9.25 / $67.70	Professional	26	$8.15	$9.25	$67.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.25 / $30.32 / $209.88	Professional	TC	$24.25	$30.32	$209.88
United Facility/Professional Professional Modifier Low / Median / High Price $30.96 / $39.34 / $72.14	Professional		$30.96	$39.34	$72.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.08 / $9.02 / $15.84	Professional	26	$8.08	$9.02	$15.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.67 / $30.32 / $48.11	Professional	TC	$23.67	$30.32	$48.11