Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.80 / $116.52 / $129.01	Facility	26	$74.80	$116.52	$129.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $345.88 / $554.62	Professional		$250.00	$345.88	$554.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $81.67 / $140.00	Professional	26	$62.50	$81.67	$140.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $264.20 / $424.52	Professional	TC	$187.50	$264.20	$424.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $465.56 / $465.56 / $465.56	Professional		$465.56	$465.56	$465.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.23 / $96.57 / $121.56	Professional	26	$57.23	$96.57	$121.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $329.70 / $452.73	Professional		$81.59	$329.70	$452.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.19 / $74.19 / $119.34	Facility	26	$74.19	$74.19	$119.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.70 / $428.19 / $666.89	Professional		$266.70	$428.19	$666.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.66 / $76.75 / $129.26	Professional	26	$66.66	$76.75	$129.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $198.03 / $344.02 / $550.00	Professional	TC	$198.03	$344.02	$550.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $558.79 / $723.52 / $723.52	Facility	26	$558.79	$723.52	$723.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $321.64 / $445.63 / $3,348.15	Professional		$321.64	$445.63	$3,348.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $66.03 / $88.15 / $586.14	Professional	26	$66.03	$88.15	$586.14
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $250.23 / $423.33 / $2,941.88	Professional	TC	$250.23	$423.33	$2,941.88
United Facility/Professional Professional Modifier Low / Median / High Price $323.08 / $386.38 / $734.92	Professional		$323.08	$386.38	$734.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.03 / $83.61 / $147.60	Professional	26	$66.03	$83.61	$147.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $250.23 / $302.23 / $605.01	Professional	TC	$250.23	$302.23	$605.01