Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.49 / $111.08 / $609.55	Facility		$49.49	$111.08	$609.55
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.26 / $21.48 / $82.80	Facility	26	$12.26	$21.48	$82.80
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $41.92 / $131.16 / $345.68	Facility	TC	$41.92	$131.16	$345.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.03 / $54.18 / $155.87	Professional		$32.03	$54.18	$155.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.35 / $11.51 / $49.18	Professional	26	$9.35	$11.51	$49.18
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.08 / $46.08 / $46.08	Professional	50	$46.08	$46.08	$46.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.55 / $35.53 / $70.67	Professional	TC	$27.55	$35.53	$70.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.90 / $41.58 / $63.28	Professional		$33.90	$41.58	$63.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.18 / $10.23 / $46.20	Professional	26	$8.18	$10.23	$46.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.23 / $43.71 / $43.71	Professional	TC	$26.23	$43.71	$43.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.15 / $94.37 / $159.47	Facility		$28.15	$94.37	$159.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.49 / $42.84 / $53.55	Professional		$37.49	$42.84	$53.55
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.40 / $9.60 / $12.60	Professional	26	$8.40	$9.60	$12.60
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.09 / $33.24 / $41.55	Professional	TC	$29.09	$33.24	$41.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.15 / $214.77 / $251.71	Facility		$165.15	$214.77	$251.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $41.38 / $41.38 / $41.38	Facility	TC	$41.38	$41.38	$41.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.70 / $50.33 / $83.49	Professional		$36.70	$50.33	$83.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.08 / $13.58 / $22.12	Professional	26	$9.08	$13.58	$22.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.82 / $36.44 / $62.50	Professional	TC	$27.82	$36.44	$62.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $43.77 / $54.24 / $129.41	Facility		$43.77	$54.24	$129.41
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $25.22 / $70.00 / $70.00	Facility	26	$25.22	$70.00	$70.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $78.56 / $168.01 / $168.01	Facility	TC	$78.56	$168.01	$168.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.47 / $45.83 / $301.95	Professional		$39.47	$45.83	$301.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.88 / $12.13 / $68.20	Professional	26	$10.88	$12.13	$68.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.59 / $34.28 / $233.75	Professional	TC	$28.59	$34.28	$233.75
United Facility/Professional Professional Modifier Low / Median / High Price $39.47 / $45.83 / $83.52	Professional		$39.47	$45.83	$83.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.87 / $11.55 / $23.05	Professional	26	$10.87	$11.55	$23.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.59 / $34.28 / $60.03	Professional	TC	$28.59	$34.28	$60.03