Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.48 / $52.47 / $311.91	Facility		$24.48	$52.47	$311.91
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.25 / $8.48 / $12.12	Facility	26	$6.25	$8.48	$12.12
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.22 / $25.21 / $188.04	Facility	TC	$18.22	$25.21	$188.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.68 / $28.46 / $32.49	Professional		$20.68	$28.46	$32.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.45 / $7.49 / $9.97	Professional	26	$5.45	$7.49	$9.97
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.34 / $14.99 / $16.25	Professional	52	$10.34	$14.99	$16.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.23 / $21.00 / $24.62	Professional	TC	$15.23	$21.00	$24.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $28.18 / $41.78	Professional		$28.18	$28.18	$41.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.73 / $7.34 / $13.19	Professional	26	$5.73	$7.34	$13.19
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.79 / $25.21 / $25.21	Professional	TC	$24.79	$25.21	$25.21
BCBS Facility/Professional Facility Modifier Low / Median / High Price $49.26 / $69.25 / $101.39	Facility		$49.26	$69.25	$101.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.05 / $29.75 / $40.85	Professional		$8.05	$29.75	$40.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.63 / $28.45 / $43.14	Facility		$24.63	$28.45	$43.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.15 / $7.15 / $11.74	Facility	26	$7.15	$7.15	$11.74
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $14.70 / $14.70 / $24.22	Facility	TC	$14.70	$14.70	$24.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.93 / $27.65 / $40.94	Professional		$21.93	$27.65	$40.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.69 / $7.91 / $12.04	Professional	26	$6.69	$7.91	$12.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.78 / $19.73 / $30.52	Professional	TC	$14.78	$19.73	$30.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $24.19 / $35.85 / $109.27	Facility		$24.19	$35.85	$109.27
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $18.09 / $100.00 / $100.00	Facility	26	$18.09	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $51.52 / $110.49 / $110.49	Facility	TC	$51.52	$110.49	$110.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.92 / $33.88 / $206.66	Professional		$25.92	$33.88	$206.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $8.66 / $67.70	Professional	26	$7.36	$8.66	$67.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $17.80 / $22.35 / $157.81	Professional	TC	$17.80	$22.35	$157.81
United Facility/Professional Facility Modifier Low / Median / High Price $121.60 / $121.60 / $136.80	Facility		$121.60	$121.60	$136.80
United Facility/Professional Professional Modifier Low / Median / High Price $25.01 / $29.78 / $48.57	Professional		$25.01	$29.78	$48.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.34 / $8.22 / $13.90	Professional	26	$7.34	$8.22	$13.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.67 / $21.11 / $36.74	Professional	TC	$17.67	$21.11	$36.74