Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $138.04 / $549.54	Facility		$41.69	$138.04	$549.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $29.51 / $83.18	Facility	26	$9.55	$29.51	$83.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $36.31 / $63.10 / $281.84	Facility	TC	$36.31	$63.10	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $40.74 / $120.23	Professional		$9.77	$40.74	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $15.14 / $47.86	Professional	26	$7.76	$15.14	$47.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.50 / $87.10 / $204.17	Professional	50	$19.50	$87.10	$204.17
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $29.51 / $29.51 / $125.89	Professional	52	$29.51	$29.51	$125.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $40.74 / $89.13	Professional	TC	$21.88	$40.74	$89.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $29.51 / $53.70	Professional		$22.91	$29.51	$53.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $7.94 / $14.13	Professional	26	$6.17	$7.94	$14.13
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $32.36 / $47.86 / $93.33	Professional	50	$32.36	$47.86	$93.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $20.89 / $45.71	Professional	TC	$17.38	$20.89	$45.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $60.26 / $93.33	Facility		$19.50	$60.26	$93.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $34.67 / $63.10	Professional		$27.54	$34.67	$63.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $7.41 / $13.18	Professional	26	$5.75	$7.41	$13.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $27.54 / $50.12	Professional	TC	$21.88	$27.54	$50.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $100.00 / $269.15	Facility		$30.90	$100.00	$269.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.46 / $30.20 / $43.65	Facility	TC	$6.46	$30.20	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $38.02 / $69.18	Professional		$28.18	$38.02	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $9.77 / $18.20	Professional	26	$6.92	$9.77	$18.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $28.18 / $53.70	Professional	TC	$20.42	$28.18	$53.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $41.69 / $204.17	Facility		$32.36	$41.69	$204.17
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $19.50 / $100.00 / $100.00	Facility	26	$19.50	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $58.88 / $125.89 / $125.89	Facility	TC	$58.88	$125.89	$125.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $35.48 / $234.42	Professional		$30.20	$35.48	$234.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $9.55 / $70.79	Professional	26	$8.13	$9.55	$70.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $26.30 / $181.97	Professional	TC	$21.88	$26.30	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $9.77 / $75.86 / $95.50	Facility		$9.77	$75.86	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $35.48 / $52.48	Professional		$28.84	$35.48	$52.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.12 / $13.80	Professional	26	$7.94	$9.12	$13.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $26.30 / $38.90	Professional	TC	$21.38	$26.30	$38.90