Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $194.98 / $501.19	Facility		$53.70	$194.98	$501.19
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.22 / $15.49 / $25.12	Facility	26	$11.22	$15.49	$25.12
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $40.74 / $123.03 / $338.84	Facility	TC	$40.74	$123.03	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $43.65 / $100.00	Professional		$10.47	$43.65	$100.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.59 / $42.66	Professional	26	$9.55	$12.59	$42.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $45.71 / $45.71 / $158.49	Professional	50	$45.71	$45.71	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $38.90 / $69.18	Professional	TC	$28.18	$38.90	$69.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $36.31 / $53.70	Professional		$29.51	$36.31	$53.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.12 / $17.38	Professional	26	$7.94	$9.12	$17.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $33.88 / $44.67	Professional	TC	$23.99	$33.88	$44.67
BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $165.96 / $229.09	Facility		$128.82	$165.96	$229.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $112.20 / $194.98	Facility		$66.07	$112.20	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $54.95 / $93.33	Professional		$33.88	$54.95	$93.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $14.13 / $23.44	Professional	26	$9.12	$14.13	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $40.74 / $72.44	Professional	TC	$25.70	$40.74	$72.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $56.23 / $109.65	Facility		$44.67	$56.23	$109.65
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $25.12 / $70.79	Facility	26	$25.12	$25.12	$70.79
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $79.43 / $79.43 / $436.52	Facility	TC	$79.43	$79.43	$436.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $51.29 / $302.00	Professional		$40.74	$51.29	$302.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $13.80 / $67.61	Professional	26	$10.96	$13.80	$67.61
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $38.02 / $234.42	Professional	TC	$29.51	$38.02	$234.42
United Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $66.07 / $97.72	Facility		$29.51	$66.07	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $45.71 / $74.13	Professional		$40.74	$45.71	$74.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $12.02 / $19.05	Professional	26	$10.96	$12.02	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $34.67 / $54.95	Professional	TC	$28.84	$34.67	$54.95