Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $13.18 / $22.91	Facility	26	$10.23	$13.18	$22.91
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $40.74 / $93.33 / $446.68	Facility	TC	$40.74	$93.33	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $46.77 / $107.15	Professional		$18.62	$46.77	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.22 / $40.74	Professional	26	$10.00	$16.22	$40.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $45.71 / $95.50 / $239.88	Professional	50	$45.71	$95.50	$239.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $38.90 / $79.43	Professional	TC	$28.18	$38.90	$79.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $37.15 / $67.61	Professional		$30.90	$37.15	$67.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.23 / $17.38	Professional	26	$7.41	$10.23	$17.38
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $45.71 / $58.88 / $102.33	Professional	50	$45.71	$58.88	$102.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $36.31 / $44.67	Professional	TC	$25.70	$36.31	$44.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Professional		$72.44	$72.44	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $53.70 / $91.20	Professional		$31.62	$53.70	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $14.45 / $25.70	Professional	26	$9.33	$14.45	$25.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $41.69 / $70.79	Professional	TC	$23.99	$41.69	$70.79
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $25.70 / $100.00	Facility	26	$25.70	$25.70	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $77.62 / $77.62 / $165.96	Facility	TC	$77.62	$77.62	$165.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $51.29 / $295.12	Professional		$37.15	$51.29	$295.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $13.80 / $87.10	Professional	26	$10.23	$13.80	$87.10
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $36.31 / $229.09	Professional	TC	$26.92	$36.31	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $44.67 / $70.79	Professional		$37.15	$44.67	$70.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $12.30 / $19.05	Professional	26	$10.23	$12.30	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $32.36 / $52.48	Professional	TC	$26.92	$32.36	$52.48