Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $239.88 / $707.95	Facility		$50.12	$239.88	$707.95
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.71 / $10.72 / $18.62	Facility	26	$8.71	$10.72	$18.62
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $35.48 / $109.65 / $363.08	Facility	TC	$35.48	$109.65	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $41.69 / $95.50	Professional		$8.91	$41.69	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.02 / $34.67	Professional	26	$7.94	$12.02	$34.67
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $25.70 / $79.43 / $194.98	Professional	50	$25.70	$79.43	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $33.11 / $63.10	Professional	TC	$24.55	$33.11	$63.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $31.62 / $51.29	Professional		$26.30	$31.62	$51.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.33 / $13.49	Professional	26	$6.61	$9.33	$13.49
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $43.65 / $47.86 / $77.62	Professional	50	$43.65	$47.86	$77.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $24.55 / $36.31	Professional	TC	$21.38	$24.55	$36.31
BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $141.25 / $229.09	Facility		$112.20	$141.25	$229.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Professional		$57.54	$57.54	$57.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $107.15 / $194.98	Facility		$83.18	$107.15	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $47.86 / $79.43	Professional		$28.18	$47.86	$79.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.02 / $19.95	Professional	26	$7.76	$12.02	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $36.31 / $61.66	Professional	TC	$20.89	$36.31	$61.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $50.12 / $97.72	Facility		$38.02	$50.12	$97.72
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $20.89 / $100.00	Facility	26	$20.89	$20.89	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $67.61 / $67.61 / $144.54	Facility	TC	$67.61	$67.61	$144.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $45.71 / $263.03	Professional		$33.11	$45.71	$263.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $11.48 / $79.43	Professional	26	$8.71	$11.48	$79.43
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $33.11 / $204.17	Professional	TC	$24.55	$33.11	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $66.07 / $97.72	Facility		$21.88	$66.07	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $38.90 / $63.10	Professional		$33.11	$38.90	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.23 / $15.85	Professional	26	$8.71	$10.23	$15.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $29.51 / $47.86	Professional	TC	$24.55	$29.51	$47.86