Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.97 / $250.87 / $604.75	Facility		$35.97	$250.87	$604.75
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.00 / $14.90 / $28.85	Facility	26	$8.00	$14.90	$28.85
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.18 / $72.02 / $345.68	Facility	TC	$27.18	$72.02	$345.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.27 / $36.65 / $106.00	Professional		$21.27	$36.65	$106.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $8.55 / $37.54	Professional	26	$6.71	$8.55	$37.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $55.28 / $94.79 / $112.62	Professional	50	$55.28	$94.79	$112.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $23.95 / $52.09	Professional	TC	$17.57	$23.95	$52.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.27 / $27.61 / $32.02	Professional		$22.27	$27.61	$32.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.85 / $8.86 / $14.26	Professional	26	$5.85	$8.86	$14.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.60 / $17.60 / $25.38	Professional	TC	$17.60	$17.60	$25.38
BCBS Facility/Professional Facility Modifier Low / Median / High Price $18.25 / $65.54 / $108.55	Facility		$18.25	$65.54	$108.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.19 / $27.65 / $34.56	Professional		$24.19	$27.65	$34.56
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.34 / $6.10 / $8.57	Professional	26	$5.34	$6.10	$8.57
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.85 / $21.54 / $26.93	Professional	TC	$18.85	$21.54	$26.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.17 / $189.46 / $247.64	Facility		$54.17	$189.46	$247.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.85 / $26.85 / $26.85	Facility	TC	$26.85	$26.85	$26.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.82 / $35.67 / $56.25	Professional		$24.82	$35.67	$56.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.52 / $9.96 / $16.80	Professional	26	$6.52	$9.96	$16.80
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.29 / $38.29 / $38.29	Professional	50	$38.29	$38.29	$38.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.50 / $24.10 / $42.07	Professional	TC	$17.50	$24.10	$42.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.36 / $37.22 / $166.26	Facility		$29.36	$37.22	$166.26
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $109.00 / $109.00 / $109.00	Facility	TC	$109.00	$109.00	$109.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.64 / $31.04 / $202.34	Professional		$26.64	$31.04	$202.34
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.92 / $8.76 / $75.00	Professional	26	$7.92	$8.76	$75.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $18.19 / $22.74 / $163.00	Professional	TC	$18.19	$22.74	$163.00
United Facility/Professional Professional Modifier Low / Median / High Price $26.64 / $31.04 / $49.66	Professional		$26.64	$31.04	$49.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $8.51 / $15.22	Professional	26	$7.79	$8.51	$15.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.19 / $22.74 / $41.70	Professional	TC	$18.19	$22.74	$41.70