Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.21 / $13.16 / $19.94	Facility	26	$10.21	$13.16	$19.94
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $40.28 / $93.54 / $417.76	Facility	TC	$40.28	$93.54	$417.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.48 / $45.04 / $73.15	Professional		$31.48	$45.04	$73.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $12.29 / $18.69	Professional	26	$10.02	$12.29	$18.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $62.96 / $62.96 / $110.60	Professional	50	$62.96	$62.96	$110.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $21.77 / $22.76 / $26.72	Professional	52	$21.77	$22.76	$26.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.87 / $34.14 / $56.24	Professional	TC	$27.87	$34.14	$56.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.64 / $40.39 / $77.79	Professional		$33.64	$40.39	$77.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.17 / $8.18 / $11.75	Professional	26	$8.17	$8.18	$11.75
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $60.58 / $60.58 / $116.69	Professional	50	$60.58	$60.58	$116.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $35.17 / $41.38 / $62.07	Professional	TC	$35.17	$41.38	$62.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.89 / $72.89 / $72.89	Professional		$72.89	$72.89	$72.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.28 / $54.44 / $83.88	Professional		$31.28	$54.44	$83.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.61 / $15.73 / $26.00	Professional	26	$9.61	$15.73	$26.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.93 / $41.85 / $69.01	Professional	TC	$23.93	$41.85	$69.01
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $25.85 / $25.85 / $100.00	Facility	26	$25.85	$25.85	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $77.14 / $77.14 / $165.02	Facility	TC	$77.14	$77.14	$165.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.40 / $49.01 / $297.63	Professional		$37.40	$49.01	$297.63
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.19 / $13.69 / $87.52	Professional	26	$10.19	$13.69	$87.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $27.21 / $36.11 / $229.42	Professional	TC	$27.21	$36.11	$229.42
United Facility/Professional Professional Modifier Low / Median / High Price $37.40 / $44.20 / $71.02	Professional		$37.40	$44.20	$71.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.19 / $12.52 / $19.21	Professional	26	$10.19	$12.52	$19.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.21 / $32.84 / $55.82	Professional	TC	$27.21	$32.84	$55.82