Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $194.98 / $691.83	Facility		$44.67	$194.98	$691.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $39.81 / $165.96	Facility	26	$10.23	$39.81	$165.96
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $40.74 / $69.18 / $208.93	Facility	TC	$40.74	$69.18	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $46.77 / $147.91	Professional		$9.77	$46.77	$147.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $16.60 / $52.48	Professional	26	$8.51	$16.60	$52.48
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $20.89 / $93.33 / $204.17	Professional	50	$20.89	$93.33	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $43.65 / $97.72	Professional	TC	$24.55	$43.65	$97.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $33.88 / $57.54	Professional		$26.30	$33.88	$57.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.12 / $16.22	Professional	26	$6.61	$9.12	$16.22
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $39.81 / $53.70 / $91.20	Professional	50	$39.81	$53.70	$91.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $23.99 / $39.81	Professional	TC	$19.50	$23.99	$39.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $64.57 / $107.15	Facility		$21.88	$64.57	$107.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $38.90 / $70.79	Professional		$30.90	$38.90	$70.79
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $8.13 / $14.45	Professional	26	$6.31	$8.13	$14.45
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $30.90 / $56.23	Professional	TC	$25.12	$30.90	$56.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $109.65 / $269.15	Facility		$34.67	$109.65	$269.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.19 / $10.23 / $14.79	Facility	26	$2.19	$10.23	$14.79
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $7.41 / $34.67 / $48.98	Facility	TC	$7.41	$34.67	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $42.66 / $77.62	Professional		$30.90	$42.66	$77.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.47 / $19.95	Professional	26	$7.59	$10.47	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $30.90 / $60.26	Professional	TC	$22.39	$30.90	$60.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $46.77 / $194.98	Facility		$35.48	$46.77	$194.98
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $100.00 / $100.00	Facility	26	$20.89	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $67.61 / $144.54 / $144.54	Facility	TC	$67.61	$144.54	$144.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $39.81 / $263.03	Professional		$33.11	$39.81	$263.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.23 / $79.43	Professional	26	$8.71	$10.23	$79.43
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $30.20 / $204.17	Professional	TC	$23.99	$30.20	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $10.72 / $75.86 / $95.50	Facility		$10.72	$75.86	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $39.81 / $58.88	Professional		$32.36	$39.81	$58.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $9.77 / $14.79	Professional	26	$8.32	$9.77	$14.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $30.20 / $43.65	Professional	TC	$23.99	$30.20	$43.65