Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.21 / $231.80 / $516.08	Facility		$34.21	$231.80	$516.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.70 / $7.48 / $13.09	Facility	26	$6.70	$7.48	$13.09
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.21 / $137.16 / $429.12	Facility	TC	$24.21	$137.16	$429.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.59 / $36.88 / $41.22	Professional		$25.59	$36.88	$41.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.67 / $8.02 / $10.57	Professional	26	$5.67	$8.02	$10.57
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $120.24 / $120.24 / $141.37	Professional	50	$120.24	$120.24	$141.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.92 / $28.75 / $32.68	Professional	TC	$19.92	$28.75	$32.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.29 / $39.90 / $54.42	Professional		$36.29	$39.90	$54.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.22 / $7.78 / $10.50	Professional	26	$6.22	$7.78	$10.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $33.64 / $35.64 / $40.13	Professional	TC	$33.64	$35.64	$40.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.61 / $69.98 / $101.39	Facility		$51.61	$69.98	$101.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.40 / $37.10 / $50.94	Professional		$8.40	$37.10	$50.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.95 / $32.95 / $46.75	Facility		$32.95	$32.95	$46.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.79 / $7.79 / $12.79	Facility	26	$7.79	$7.79	$12.79
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $19.64 / $19.64 / $26.16	Facility	TC	$19.64	$19.64	$26.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.81 / $33.76 / $52.71	Professional		$27.81	$33.76	$52.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.25 / $8.25 / $13.04	Professional	26	$7.25	$8.25	$13.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.02 / $25.51 / $41.41	Professional	TC	$20.02	$25.51	$41.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.64 / $45.57 / $132.52	Facility		$30.64	$45.57	$132.52
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $100.00 / $100.00	Facility	26	$19.60	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $70.01 / $149.85 / $204.28	Facility	TC	$70.01	$149.85	$204.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.97 / $39.59 / $263.06	Professional		$31.97	$39.59	$263.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.67 / $9.46 / $67.70	Professional	26	$7.67	$9.46	$67.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.42 / $28.80 / $209.88	Professional	TC	$23.42	$28.80	$209.88
United Facility/Professional Facility Modifier Low / Median / High Price $152.00 / $152.00 / $171.00	Facility		$152.00	$152.00	$171.00
United Facility/Professional Professional Modifier Low / Median / High Price $30.77 / $36.97 / $59.32	Professional		$30.77	$36.97	$59.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.67 / $8.57 / $14.43	Professional	26	$7.67	$8.57	$14.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.74 / $27.51 / $45.48	Professional	TC	$22.74	$27.51	$45.48