Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $229.09 / $645.65	Facility	26	$125.89	$229.09	$645.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $371.54 / $1,380.38	Professional		$109.65	$371.54	$1,380.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $131.83 / $380.19	Professional	26	$63.10	$131.83	$380.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $263.03 / $478.63 / $1,778.28	Professional	50	$263.03	$478.63	$1,778.28
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $31.62 / $162.18 / $1,023.29	Professional	52	$31.62	$162.18	$1,023.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $302.00 / $933.25	Professional	TC	$147.91	$302.00	$933.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $190.55 / $316.23	Professional		$147.91	$190.55	$316.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $60.26 / $109.65	Professional	26	$47.86	$60.26	$109.65
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $512.86 / $512.86 / $512.86	Professional	50	$512.86	$512.86	$512.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $134.90 / $239.88	Professional	TC	$100.00	$134.90	$239.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $263.03 / $467.74	Professional		$204.17	$263.03	$467.74
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $72.44 / $125.89	Professional	26	$56.23	$72.44	$125.89
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $190.55 / $338.84	Professional	TC	$147.91	$190.55	$338.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.49 / $72.44 / $104.71	Facility	26	$15.49	$72.44	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $371.54 / $660.69	Professional		$169.82	$371.54	$660.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $74.13 / $138.04	Professional	26	$50.12	$74.13	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $263.03 / $524.81	Professional	TC	$117.49	$263.03	$524.81
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $467.74 / $602.56 / $602.56	Facility	26	$467.74	$602.56	$602.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $416.87 / $2,818.38	Professional		$199.53	$416.87	$2,818.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $69.18 / $524.81	Professional	26	$54.95	$69.18	$524.81
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $851.14 / $851.14 / $851.14	Professional	50	$851.14	$851.14	$851.14
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $338.84 / $2,454.71	Professional	TC	$138.04	$338.84	$2,454.71
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $309.03 / $524.81	Professional		$199.53	$309.03	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $58.88 / $104.71	Professional	26	$54.95	$58.88	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $229.09 / $446.68	Professional	TC	$138.04	$229.09	$446.68