Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.45 / $72.22 / $83.76	Facility	26	$53.45	$72.22	$83.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $167.29 / $202.54 / $300.00	Professional		$167.29	$202.54	$300.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $58.32 / $73.84	Professional	26	$51.30	$58.32	$73.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $111.53 / $133.77 / $224.62	Professional	TC	$111.53	$133.77	$224.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.61 / $50.94 / $86.57	Professional	26	$40.61	$50.94	$86.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $128.82 / $256.75	Professional	TC	$128.82	$128.82	$256.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.70 / $167.30 / $229.73	Professional		$57.70	$167.30	$229.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.63 / $53.63 / $85.48	Facility	26	$53.63	$53.63	$85.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.03 / $240.82 / $378.00	Professional		$144.03	$240.82	$378.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.71 / $54.32 / $91.49	Professional	26	$47.71	$54.32	$91.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.13 / $185.88 / $293.19	Professional	TC	$95.13	$185.88	$293.19
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $397.76 / $514.88 / $514.88	Facility	26	$397.76	$514.88	$514.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $171.12 / $254.76 / $1,638.03	Professional		$171.12	$254.76	$1,638.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $47.35 / $63.13 / $376.34	Professional	26	$47.35	$63.13	$376.34
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $119.62 / $203.81 / $1,335.34	Professional	TC	$119.62	$203.81	$1,335.34
United Facility/Professional Professional Modifier Low / Median / High Price $157.35 / $210.15 / $377.45	Professional		$157.35	$210.15	$377.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.35 / $59.19 / $88.51	Professional	26	$47.35	$59.19	$88.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $119.62 / $158.12 / $270.19	Professional	TC	$119.62	$158.12	$270.19