Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $102.33 / $117.49	Facility	26	$74.13	$102.33	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $275.42 / $501.19	Professional		$102.33	$275.42	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $107.15 / $257.04	Professional	26	$61.66	$107.15	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $223.87 / $416.87	Professional	TC	$141.25	$223.87	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $169.82 / $309.03	Professional		$138.04	$169.82	$309.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $61.66 / $102.33	Professional	26	$47.86	$61.66	$102.33
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $295.12 / $295.12 / $295.12	Professional	50	$295.12	$295.12	$295.12
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $107.15 / $204.17	Professional	TC	$77.62	$107.15	$204.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $208.93 / $281.84	Professional		$64.57	$208.93	$281.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $61.66 / $100.00	Facility	26	$61.66	$61.66	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $389.05 / $588.84	Professional		$186.21	$389.05	$588.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $66.07 / $134.90	Professional	26	$53.70	$66.07	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $302.00 / $489.78	Professional	TC	$131.83	$302.00	$489.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $467.74 / $602.56 / $602.56	Facility	26	$467.74	$602.56	$602.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $288.40 / $2,818.38	Professional		$199.53	$288.40	$2,818.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $72.44 / $537.03	Professional	26	$56.23	$72.44	$537.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $281.84 / $2,454.71	Professional	TC	$141.25	$281.84	$2,454.71
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $251.19 / $660.69	Professional		$199.53	$251.19	$660.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $70.79 / $104.71	Professional	26	$54.95	$70.79	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $169.82 / $575.44	Professional	TC	$138.04	$169.82	$575.44