Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.85 / $138.60 / $242.14	Facility	26	$90.85	$138.60	$242.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $222.92 / $475.00 / $1,189.00	Professional		$222.92	$475.00	$1,189.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.15 / $140.00 / $284.00	Professional	26	$68.15	$140.00	$284.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,218.00 / $1,218.00 / $1,218.00	Professional	50	$1,218.00	$1,218.00	$1,218.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $107.68 / $187.50 / $237.50	Professional	52	$107.68	$187.50	$237.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $172.56 / $335.00 / $441.00	Professional	TC	$172.56	$335.00	$441.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $153.51 / $180.57 / $208.22	Professional		$153.51	$180.57	$208.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.87 / $68.22 / $118.49	Professional	26	$48.87	$68.22	$118.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $135.18 / $135.18 / $135.18	Professional	TC	$135.18	$135.18	$135.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $205.29 / $234.62 / $293.27	Professional		$205.29	$234.62	$293.27
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.83 / $63.80 / $79.98	Professional	26	$55.83	$63.80	$79.98
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $149.46 / $170.82 / $213.52	Professional	TC	$149.46	$170.82	$213.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.64 / $73.64 / $73.64	Facility	26	$73.64	$73.64	$73.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.71 / $416.20 / $683.82	Professional		$169.71	$416.20	$683.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.12 / $80.22 / $139.41	Professional	26	$47.12	$80.22	$139.41
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $301.29 / $301.29 / $301.29	Professional	50	$301.29	$301.29	$301.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $120.81 / $299.14 / $538.37	Professional	TC	$120.81	$299.14	$538.37
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $603.28 / $603.28 / $603.28	Facility	26	$603.28	$603.28	$603.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $198.48 / $443.65 / $2,789.74	Professional		$198.48	$443.65	$2,789.74
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $54.76 / $67.05 / $542.85	Professional	26	$54.76	$67.05	$542.85
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $138.66 / $349.22 / $2,451.15	Professional	TC	$138.66	$349.22	$2,451.15
United Facility/Professional Professional Modifier Low / Median / High Price $198.48 / $334.93 / $579.59	Professional		$198.48	$334.93	$579.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.76 / $59.82 / $122.40	Professional	26	$54.76	$59.82	$122.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.66 / $255.74 / $433.14	Professional	TC	$138.66	$255.74	$433.14