Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $114.82 / $512.86	Facility		$41.69	$114.82	$512.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $38.02 / $51.29	Facility	26	$12.30	$38.02	$51.29
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $39.81 / $117.49 / $199.53	Facility	TC	$39.81	$117.49	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $48.98 / $147.91	Professional		$33.11	$48.98	$147.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.13 / $41.69	Professional	26	$8.91	$14.13	$41.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $26.92 / $50.12 / $194.98	Professional	50	$26.92	$50.12	$194.98
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.78 / $17.78 / $17.78	Professional	52	$17.78	$17.78	$17.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $30.90 / $77.62	Professional	TC	$22.91	$30.90	$77.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $33.88 / $61.66	Professional		$25.70	$33.88	$61.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $8.71 / $17.78	Professional	26	$7.94	$8.71	$17.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $23.99 / $41.69	Professional	TC	$19.05	$23.99	$41.69
BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $75.86 / $107.15	Facility		$21.38	$75.86	$107.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $40.74 / $74.13	Professional		$32.36	$40.74	$74.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.72 / $19.05	Professional	26	$8.32	$10.72	$19.05
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $30.20 / $54.95	Professional	TC	$23.99	$30.20	$54.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $288.40 / $380.19	Facility		$42.66	$288.40	$380.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.63 / $12.30 / $17.38	Facility	26	$2.63	$12.30	$17.38
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $7.08 / $33.11 / $47.86	Facility	TC	$7.08	$33.11	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $47.86 / $79.43	Professional		$33.11	$47.86	$79.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $13.49 / $23.44	Professional	26	$9.12	$13.49	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $33.11 / $58.88	Professional	TC	$23.44	$33.11	$58.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $50.12 / $109.65	Facility		$37.15	$50.12	$109.65
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $70.79 / $70.79	Facility	26	$25.12	$70.79	$70.79
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $64.57 / $138.04 / $138.04	Facility	TC	$64.57	$138.04	$138.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $41.69 / $263.03	Professional		$38.02	$41.69	$263.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $12.59 / $67.61	Professional	26	$10.96	$12.59	$67.61
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $29.51 / $194.98	Professional	TC	$26.30	$29.51	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $91.20 / $134.90	Facility		$13.49	$91.20	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $40.74 / $63.10	Professional		$38.02	$40.74	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $11.75 / $18.62	Professional	26	$10.96	$11.75	$18.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $28.84 / $44.67	Professional	TC	$26.30	$28.84	$44.67