Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.92 / $162.36 / $452.97	Facility		$22.92	$162.36	$452.97
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.00 / $7.44 / $11.20	Facility	26	$6.00	$7.44	$11.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.39 / $27.20 / $202.73	Facility	TC	$16.39	$27.20	$202.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.12 / $26.63 / $30.16	Professional		$18.12	$26.63	$30.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $7.09 / $7.83	Professional	26	$5.01	$7.09	$7.83
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $9.06 / $13.32 / $14.23	Professional	52	$9.06	$13.32	$14.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.10 / $19.45 / $22.31	Professional	TC	$13.10	$19.45	$22.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.01 / $28.20 / $39.58	Professional		$20.01	$28.20	$39.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.50 / $6.88 / $11.65	Professional	26	$5.50	$6.88	$11.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.39 / $21.39 / $23.57	Professional	TC	$21.39	$21.39	$23.57
BCBS Facility/Professional Facility Modifier Low / Median / High Price $52.11 / $69.98 / $101.39	Facility		$52.11	$69.98	$101.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.35 / $26.25 / $36.04	Professional		$7.35	$26.25	$36.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.30 / $28.45 / $43.14	Facility		$21.30	$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 $14.12 / $14.12 / $24.22	Facility	TC	$14.12	$14.12	$24.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.35 / $24.45 / $39.36	Professional		$21.35	$24.45	$39.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.42 / $7.30 / $11.56	Professional	26	$6.42	$7.30	$11.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.19 / $17.41 / $27.82	Professional	TC	$14.19	$17.41	$27.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $21.22 / $34.09 / $68.28	Facility		$21.22	$34.09	$68.28
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $17.46 / $100.00 / $100.00	Facility	26	$17.46	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $44.39 / $100.00 / $136.58	Facility	TC	$44.39	$100.00	$136.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.90 / $31.26 / $180.63	Professional		$23.90	$31.26	$180.63
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $6.79 / $8.31 / $67.70	Professional	26	$6.79	$8.31	$67.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $16.17 / $20.21 / $154.00	Professional	TC	$16.17	$20.21	$154.00
United Facility/Professional Facility Modifier Low / Median / High Price $103.36 / $103.36 / $116.28	Facility		$103.36	$103.36	$116.28
United Facility/Professional Professional Modifier Low / Median / High Price $22.52 / $26.91 / $45.04	Professional		$22.52	$26.91	$45.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.75 / $7.59 / $12.01	Professional	26	$6.75	$7.59	$12.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.34 / $19.32 / $32.34	Professional	TC	$15.34	$19.32	$32.34