Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $257.04 / $707.95	Facility		$52.48	$257.04	$707.95
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $9.77 / $16.60	Facility	26	$7.94	$9.77	$16.60
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.55 / $245.47 / $489.78	Facility	TC	$24.55	$245.47	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $39.81 / $67.61	Professional		$30.90	$39.81	$67.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.72 / $26.92	Professional	26	$7.94	$10.72	$26.92
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $120.23 / $120.23 / $147.91	Professional	50	$120.23	$120.23	$147.91
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 $21.88 / $28.84 / $50.12	Professional	TC	$21.88	$28.84	$50.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $30.90 / $53.70	Professional		$25.12	$30.90	$53.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $8.32 / $17.38	Professional	26	$7.94	$8.32	$17.38
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $15.14 / $15.14 / $15.14	Professional	52	$15.14	$15.14	$15.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $32.36 / $45.71	Professional	TC	$19.05	$32.36	$45.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $75.86 / $102.33	Facility		$51.29	$75.86	$102.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $38.02 / $52.48	Professional		$10.96	$38.02	$52.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $30.90 / $398.11	Facility		$30.90	$30.90	$398.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $17.38 / $17.38	Facility	26	$17.38	$17.38	$17.38
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $38.02 / $38.02 / $38.02	Facility	TC	$38.02	$38.02	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $38.90 / $63.10	Professional		$28.84	$38.90	$63.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.75 / $19.95	Professional	26	$8.91	$11.75	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $27.54 / $47.86	Professional	TC	$19.95	$27.54	$47.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $51.29 / $346.74	Facility		$31.62	$51.29	$346.74
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 $34.67 / $41.69 / $263.03	Professional		$34.67	$41.69	$263.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $12.59 / $67.61	Professional	26	$9.77	$12.59	$67.61
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $29.51 / $194.98	Professional	TC	$23.44	$29.51	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $81.28 / $257.04	Facility		$28.18	$81.28	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $38.90 / $60.26	Professional		$32.36	$38.90	$60.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $11.48 / $17.78	Professional	26	$9.77	$11.48	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $27.54 / $42.66	Professional	TC	$22.91	$27.54	$42.66