Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $38.02 / $83.18	Facility	26	$12.59	$38.02	$83.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $46.77 / $77.62 / $371.54	Facility	TC	$46.77	$77.62	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $54.95 / $173.78	Professional		$19.05	$54.95	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $22.39 / $64.57	Professional	26	$10.00	$22.39	$64.57
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.90 / $114.82 / $269.15	Professional	50	$38.90	$114.82	$269.15
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $43.65 / $43.65 / $43.65	Professional	52	$43.65	$43.65	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $44.67 / $114.82	Professional	TC	$28.18	$44.67	$114.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $39.81 / $72.44	Professional		$30.90	$39.81	$72.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.00 / $17.78	Professional	26	$8.13	$10.00	$17.78
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $51.29 / $61.66 / $114.82	Professional	50	$51.29	$61.66	$114.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $30.90 / $58.88	Professional	TC	$25.12	$30.90	$58.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $44.67 / $83.18	Professional		$36.31	$44.67	$83.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.77 / $17.38	Professional	26	$7.59	$9.77	$17.38
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $35.48 / $64.57	Professional	TC	$28.84	$35.48	$64.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.69 / $12.59 / $17.78	Facility	26	$2.69	$12.59	$17.78
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $8.51 / $39.81 / $56.23	Facility	TC	$8.51	$39.81	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $47.86 / $89.13	Professional		$35.48	$47.86	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.88 / $23.99	Professional	26	$9.12	$12.88	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $34.67 / $66.07	Professional	TC	$25.70	$34.67	$66.07
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $100.00 / $100.00	Facility	26	$25.70	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $77.62 / $165.96 / $165.96	Facility	TC	$77.62	$165.96	$165.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $45.71 / $295.12	Professional		$38.02	$45.71	$295.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $12.30 / $87.10	Professional	26	$10.23	$12.30	$87.10
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $33.88 / $229.09	Professional	TC	$27.54	$33.88	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $44.67 / $66.07	Professional		$36.31	$44.67	$66.07
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 $26.92 / $33.11 / $47.86	Professional	TC	$26.92	$33.11	$47.86