Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.56 / $231.80 / $426.75	Facility		$62.56	$231.80	$426.75
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.24 / $9.19 / $14.08	Facility	26	$7.24	$9.19	$14.08
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.72 / $118.87 / $259.20	Facility	TC	$23.72	$118.87	$259.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.64 / $36.89 / $41.22	Professional		$26.64	$36.89	$41.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.11 / $8.65 / $11.32	Professional	26	$6.11	$8.65	$11.32
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $121.55 / $121.55 / $121.55	Professional	50	$121.55	$121.55	$121.55
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.80 / $18.96 / $20.61	Professional	52	$12.80	$18.96	$20.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.48 / $27.69 / $32.01	Professional	TC	$19.48	$27.69	$32.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.86 / $39.31 / $52.79	Professional		$28.86	$39.31	$52.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $7.13 / $14.21	Professional	26	$6.71	$7.13	$14.21
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $79.18 / $79.18 / $79.18	Professional	50	$79.18	$79.18	$79.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.27 / $32.82 / $37.38	Professional	TC	$32.27	$32.82	$37.38
BCBS Facility/Professional Facility Modifier Low / Median / High Price $54.12 / $69.98 / $101.39	Facility		$54.12	$69.98	$101.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.10 / $37.10 / $50.94	Professional		$9.10	$37.10	$50.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.96 / $31.96 / $50.34	Facility		$31.96	$31.96	$50.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.42 / $8.42 / $13.36	Facility	26	$8.42	$8.42	$13.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $19.21 / $19.21 / $28.54	Facility	TC	$19.21	$19.21	$28.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.78 / $34.11 / $52.68	Professional		$27.78	$34.11	$52.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.96 / $8.94 / $14.74	Professional	26	$7.96	$8.94	$14.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.21 / $25.21 / $39.74	Professional	TC	$19.21	$25.21	$39.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.67 / $45.39 / $220.19	Facility		$30.67	$45.39	$220.19
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $21.10 / $100.00 / $100.00	Facility	26	$21.10	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $67.18 / $143.82 / $144.00	Facility	TC	$67.18	$143.82	$144.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.89 / $40.79 / $263.06	Professional		$31.89	$40.79	$263.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.47 / $10.06 / $79.26	Professional	26	$8.47	$10.06	$79.26
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.74 / $28.46 / $205.55	Professional	TC	$22.74	$28.46	$205.55
United Facility/Professional Facility Modifier Low / Median / High Price $149.94 / $149.94 / $149.94	Facility		$149.94	$149.94	$149.94
United Facility/Professional Professional Modifier Low / Median / High Price $31.11 / $36.67 / $59.92	Professional		$31.11	$36.67	$59.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $9.26 / $15.58	Professional	26	$8.27	$9.26	$15.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.26 / $27.75 / $44.94	Professional	TC	$22.26	$27.75	$44.94