Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $213.80 / $512.86	Facility		$45.71	$213.80	$512.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $10.00 / $17.38	Facility	26	$7.94	$10.00	$17.38
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.36 / $114.82 / $363.08	Facility	TC	$32.36	$114.82	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $35.48 / $75.86	Professional		$9.55	$35.48	$75.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $11.22 / $34.67	Professional	26	$7.41	$11.22	$34.67
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $91.20 / $213.80	Professional	50	$42.66	$91.20	$213.80
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $60.26 / $60.26 / $60.26	Professional	52	$60.26	$60.26	$60.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.20 / $57.54	Professional	TC	$21.88	$30.20	$57.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $27.54 / $47.86	Professional		$22.91	$27.54	$47.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $7.08 / $13.49	Professional	26	$6.17	$7.08	$13.49
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $41.69 / $41.69 / $46.77	Professional	50	$41.69	$41.69	$46.77
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.12 / $36.31	Professional	TC	$18.20	$25.12	$36.31
BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $131.83 / $213.80	Facility		$104.71	$131.83	$213.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Professional		$52.48	$52.48	$52.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $107.15 / $194.98	Facility		$83.18	$107.15	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $41.69 / $72.44	Professional		$25.12	$41.69	$72.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.96 / $18.20	Professional	26	$7.08	$10.96	$18.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $32.36 / $54.95	Professional	TC	$18.62	$32.36	$54.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $48.98 / $218.78	Facility		$34.67	$48.98	$218.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $19.50 / $19.50 / $100.00	Facility	26	$19.50	$19.50	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $58.88 / $125.89 / $398.11	Facility	TC	$58.88	$125.89	$398.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $40.74 / $234.42	Professional		$30.20	$40.74	$234.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.22 / $70.79	Professional	26	$8.32	$11.22	$70.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $29.51 / $181.97	Professional	TC	$21.88	$29.51	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $66.07 / $97.72	Facility		$19.50	$66.07	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $35.48 / $56.23	Professional		$30.20	$35.48	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $9.12 / $14.45	Professional	26	$8.32	$9.12	$14.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $25.70 / $41.69	Professional	TC	$21.88	$25.70	$41.69