Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $223.87 / $537.03	Facility		$44.67	$223.87	$537.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $9.55 / $16.60	Facility	26	$7.59	$9.55	$16.60
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.51 / $107.15 / $457.09	Facility	TC	$29.51	$107.15	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $34.67 / $87.10	Professional		$8.13	$34.67	$87.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.48 / $36.31	Professional	26	$7.08	$11.48	$36.31
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $34.67 / $74.13 / $169.82	Professional	50	$34.67	$74.13	$169.82
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $3.80 / $3.80 / $3.80	Professional	52	$3.80	$3.80	$3.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.84 / $60.26	Professional	TC	$20.89	$28.84	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $25.70 / $43.65	Professional		$21.38	$25.70	$43.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $6.76 / $12.02	Professional	26	$5.89	$6.76	$12.02
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $31.62 / $38.90 / $45.71	Professional	50	$31.62	$38.90	$45.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $23.44 / $33.11	Professional	TC	$17.78	$23.44	$33.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $128.82 / $204.17	Facility		$100.00	$128.82	$204.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Professional		$48.98	$48.98	$48.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $107.15 / $194.98	Facility		$79.43	$107.15	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $40.74 / $67.61	Professional		$23.44	$40.74	$67.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $10.72 / $19.05	Professional	26	$6.76	$10.72	$19.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $30.90 / $51.29	Professional	TC	$18.20	$30.90	$51.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $41.69 / $97.72	Facility		$32.36	$41.69	$97.72
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $19.05 / $100.00	Facility	26	$19.05	$19.05	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $54.95 / $117.49 / $371.54	Facility	TC	$54.95	$117.49	$371.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $38.90 / $223.87	Professional		$30.20	$38.90	$223.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.47 / $70.79	Professional	26	$8.32	$10.47	$70.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.18 / $169.82	Professional	TC	$21.88	$28.18	$169.82
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 / $33.11 / $53.70	Professional		$30.20	$33.11	$53.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $8.91 / $14.13	Professional	26	$8.32	$8.91	$14.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $23.99 / $38.90	Professional	TC	$21.88	$23.99	$38.90