Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.20 / $87.72 / $414.64	Facility		$38.20	$87.72	$414.64
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.07 / $9.51 / $14.35	Facility	26	$8.07	$9.51	$14.35
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.78 / $40.67 / $364.53	Facility	TC	$27.78	$40.67	$364.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.43 / $30.91 / $37.33	Professional		$18.43	$30.91	$37.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $9.14 / $13.98	Professional	26	$7.03	$9.14	$13.98
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.94 / $15.94 / $18.67	Professional	52	$13.94	$15.94	$18.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $23.87 / $40.04	Professional	TC	$18.53	$23.87	$40.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.71 / $22.71 / $22.71	Professional		$22.71	$22.71	$22.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.69 / $5.73 / $8.89	Professional	26	$5.69	$5.73	$8.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.07 / $18.07 / $18.07	Professional	TC	$18.07	$18.07	$18.07
BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.09 / $104.07 / $396.45	Facility		$76.09	$104.07	$396.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.32 / $47.32 / $47.32	Professional		$47.32	$47.32	$47.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.20 / $112.50 / $241.75	Facility		$43.20	$112.50	$241.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.03 / $38.15 / $57.35	Professional		$22.03	$38.15	$57.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $11.45 / $15.00	Professional	26	$6.71	$11.45	$15.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.90 / $28.66 / $47.69	Professional	TC	$15.90	$28.66	$47.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.91 / $37.33 / $65.98	Facility		$30.91	$37.33	$65.98
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $18.09 / $18.09 / $100.00	Facility	26	$18.09	$18.09	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $51.52 / $51.52 / $110.49	Facility	TC	$51.52	$51.52	$110.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.65 / $36.18 / $206.66	Professional		$26.65	$36.18	$206.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $10.26 / $67.70	Professional	26	$7.56	$10.26	$67.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.09 / $25.97 / $157.81	Professional	TC	$19.09	$25.97	$157.81
United Facility/Professional Facility Modifier Low / Median / High Price $84.95 / $90.54 / $177.49	Facility		$84.95	$90.54	$177.49
United Facility/Professional Professional Modifier Low / Median / High Price $26.65 / $32.11 / $51.39	Professional		$26.65	$32.11	$51.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $9.11 / $14.14	Professional	26	$7.56	$9.11	$14.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.09 / $23.18 / $39.88	Professional	TC	$19.09	$23.18	$39.88