Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.47 / $79.59 / $440.80	Facility		$41.47	$79.59	$440.80
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.26 / $20.76 / $40.15	Facility	26	$12.26	$20.76	$40.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $34.74 / $73.31 / $410.65	Facility	TC	$34.74	$73.31	$410.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.25 / $42.13 / $101.70	Professional		$34.25	$42.13	$101.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.98 / $10.90 / $25.02	Professional	26	$8.98	$10.90	$25.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.28 / $38.29 / $38.29	Professional	50	$38.28	$38.29	$38.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.71 / $27.94 / $57.56	Professional	TC	$23.71	$27.94	$57.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.40 / $39.21 / $41.83	Professional		$28.40	$39.21	$41.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.14 / $10.17 / $24.41	Professional	26	$8.14	$10.17	$24.41
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.98 / $28.98 / $28.98	Professional	TC	$28.98	$28.98	$28.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.53 / $84.30 / $138.75	Facility		$22.53	$84.30	$138.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.50 / $37.14 / $46.43	Professional		$32.50	$37.14	$46.43
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.40 / $9.60 / $12.00	Professional	26	$8.40	$9.60	$12.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.10 / $27.54 / $34.43	Professional	TC	$24.10	$27.54	$34.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $233.08 / $290.33 / $397.00	Facility		$233.08	$290.33	$397.00
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 $34.29 / $34.29 / $34.29	Facility	TC	$34.29	$34.29	$34.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.25 / $48.22 / $76.23	Professional		$34.25	$48.22	$76.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.08 / $13.78 / $22.81	Professional	26	$9.08	$13.78	$22.81
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $49.64 / $49.64 / $49.64	Professional	50	$49.64	$49.64	$49.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.49 / $33.18 / $53.85	Professional	TC	$24.49	$33.18	$53.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.29 / $47.05 / $109.51	Facility		$38.29	$47.05	$109.51
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 $65.04 / $139.28 / $139.28	Facility	TC	$65.04	$139.28	$139.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.78 / $42.07 / $265.10	Professional		$37.78	$42.07	$265.10
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.21 / $12.51 / $68.20	Professional	26	$11.21	$12.51	$68.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.55 / $29.56 / $196.89	Professional	TC	$26.55	$29.56	$196.89
United Facility/Professional Professional Modifier Low / Median / High Price $37.78 / $40.42 / $72.14	Professional		$37.78	$40.42	$72.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.91 / $11.82 / $21.18	Professional	26	$10.91	$11.82	$21.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.55 / $28.87 / $50.68	Professional	TC	$26.55	$28.87	$50.68