Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.96 / $242.53 / $611.82	Facility		$49.96	$242.53	$611.82
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.78 / $10.74 / $14.66	Facility	26	$8.78	$10.74	$14.66
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $35.74 / $127.50 / $362.95	Facility	TC	$35.74	$127.50	$362.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.76 / $39.64 / $68.86	Professional		$22.76	$39.64	$68.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $10.30 / $27.24	Professional	26	$8.56	$10.30	$27.24
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $54.62 / $54.62 / $88.39	Professional	50	$54.62	$54.62	$88.39
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $18.92 / $19.82 / $23.24	Professional	52	$18.92	$19.82	$23.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.44 / $30.64 / $54.62	Professional	TC	$24.44	$30.64	$54.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.85 / $32.01 / $66.70	Professional		$28.85	$32.01	$66.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.67 / $6.69 / $9.59	Professional	26	$6.67	$6.69	$9.59
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $43.28 / $48.02 / $48.02	Professional	50	$43.28	$48.02	$48.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $27.10 / $36.04 / $36.04	Professional	TC	$27.10	$36.04	$36.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.40 / $149.60 / $591.41	Facility		$109.40	$149.60	$591.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.33 / $57.33 / $57.33	Professional		$57.33	$57.33	$57.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.47 / $112.50 / $241.75	Facility		$55.47	$112.50	$241.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.07 / $49.34 / $72.63	Professional		$27.07	$49.34	$72.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $13.07 / $18.00	Professional	26	$8.11	$13.07	$18.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.87 / $37.63 / $61.27	Professional	TC	$20.87	$37.63	$61.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.45 / $46.48 / $86.50	Facility		$38.45	$46.48	$86.50
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $21.10 / $21.10 / $100.00	Facility	26	$21.10	$21.10	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $67.18 / $67.18 / $143.82	Facility	TC	$67.18	$67.18	$143.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.97 / $44.01 / $263.06	Professional		$32.97	$44.01	$263.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.69 / $11.54 / $79.26	Professional	26	$8.69	$11.54	$79.26
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.29 / $32.96 / $205.55	Professional	TC	$24.29	$32.96	$205.55
United Facility/Professional Facility Modifier Low / Median / High Price $115.61 / $115.61 / $115.61	Facility		$115.61	$115.61	$115.61
United Facility/Professional Professional Modifier Low / Median / High Price $32.97 / $39.70 / $63.92	Professional		$32.97	$39.70	$63.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.69 / $10.34 / $16.12	Professional	26	$8.69	$10.34	$16.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.29 / $29.59 / $50.93	Professional	TC	$24.29	$29.59	$50.93