Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $190.55 / $263.03	Facility	26	$72.44	$190.55	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $204.17 / $524.81	Professional		$107.15	$204.17	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $97.72 / $223.87	Professional	26	$51.29	$97.72	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $181.97 / $426.58	Professional	TC	$112.20	$181.97	$426.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $194.98	Professional		$165.96	$165.96	$194.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $50.12 / $100.00	Professional	26	$40.74	$50.12	$100.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $213.80 / $380.19	Professional		$165.96	$213.80	$380.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $61.66 / $109.65	Professional	26	$47.86	$61.66	$109.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $154.88 / $275.42	Professional	TC	$120.23	$154.88	$275.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $61.66 / $89.13	Facility	26	$13.49	$61.66	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $257.04 / $489.78	Professional		$138.04	$257.04	$489.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $64.57 / $117.49	Professional	26	$41.69	$64.57	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $186.21 / $363.08	Professional	TC	$97.72	$186.21	$363.08
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $398.11 / $512.86 / $512.86	Facility	26	$398.11	$512.86	$512.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $275.42 / $1,621.81	Professional		$165.96	$275.42	$1,621.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $58.88 / $380.19	Professional	26	$47.86	$58.88	$380.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $229.09 / $1,348.96	Professional	TC	$117.49	$229.09	$1,348.96
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $245.47 / $389.05	Professional		$165.96	$245.47	$389.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $50.12 / $93.33	Professional	26	$47.86	$50.12	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $194.98 / $295.12	Professional	TC	$117.49	$194.98	$295.12