Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.90 / $203.52 / $420.30	Facility		$55.90	$203.52	$420.30
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.60 / $8.71 / $15.03	Facility	26	$8.60	$8.71	$15.03
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.96 / $196.54 / $426.40	Facility	TC	$26.96	$196.54	$426.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.49 / $40.07 / $47.27	Professional		$29.49	$40.07	$47.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.23 / $10.19 / $10.90	Professional	26	$7.23	$10.19	$10.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.26 / $29.60 / $36.36	Professional	TC	$22.26	$29.60	$36.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.54 / $41.94 / $64.31	Professional		$33.54	$41.94	$64.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.97 / $9.97 / $16.93	Professional	26	$7.97	$9.97	$16.93
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.72 / $38.36 / $46.73	Professional	TC	$37.72	$38.36	$46.73
BCBS Facility/Professional Facility Modifier Low / Median / High Price $52.11 / $69.98 / $101.39	Facility		$52.11	$69.98	$101.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.85 / $42.70 / $58.63	Professional		$10.85	$42.70	$58.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.95 / $36.95 / $113.07	Facility		$36.95	$36.95	$113.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.09 / $17.09 / $17.09	Facility	26	$17.09	$17.09	$17.09
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $40.51 / $40.51 / $40.51	Facility	TC	$40.51	$40.51	$40.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.37 / $39.44 / $60.92	Professional		$31.37	$39.44	$60.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.96 / $10.57 / $16.12	Professional	26	$8.96	$10.57	$16.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.41 / $28.85 / $46.43	Professional	TC	$22.41	$28.85	$46.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.25 / $53.95 / $236.28	Facility		$35.25	$53.95	$236.28
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 $36.65 / $45.94 / $301.95	Professional		$36.65	$45.94	$301.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.84 / $12.13 / $68.20	Professional	26	$9.84	$12.13	$68.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.71 / $32.57 / $233.75	Professional	TC	$25.71	$32.57	$233.75
United Facility/Professional Facility Modifier Low / Median / High Price $172.22 / $172.22 / $193.75	Facility		$172.22	$172.22	$193.75
United Facility/Professional Professional Modifier Low / Median / High Price $35.65 / $43.96 / $69.59	Professional		$35.65	$43.96	$69.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.84 / $12.10 / $17.32	Professional	26	$9.84	$12.10	$17.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $31.83 / $54.12	Professional	TC	$25.12	$31.83	$54.12