Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.85 / $138.60 / $592.50	Facility	26	$90.85	$138.60	$592.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.84 / $475.00 / $1,190.00	Professional		$213.84	$475.00	$1,190.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.73 / $140.00 / $334.40	Professional	26	$67.73	$140.00	$334.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $475.00 / $475.00 / $475.00	Professional	50	$475.00	$475.00	$475.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $107.51 / $187.50 / $237.50	Professional	52	$107.51	$187.50	$237.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $172.16 / $335.00 / $502.50	Professional	TC	$172.16	$335.00	$502.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.74 / $180.28 / $219.41	Professional		$141.74	$180.28	$219.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.61 / $54.31 / $118.49	Professional	26	$48.61	$54.31	$118.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $104.65 / $134.86 / $134.86	Professional	TC	$104.65	$134.86	$134.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.94 / $234.22 / $292.77	Professional		$204.94	$234.22	$292.77
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.83 / $63.80 / $79.98	Professional	26	$55.83	$63.80	$79.98
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $149.11 / $170.42 / $213.02	Professional	TC	$149.11	$170.42	$213.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.64 / $73.64 / $73.64	Facility	26	$73.64	$73.64	$73.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.21 / $417.57 / $709.45	Professional		$169.21	$417.57	$709.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.07 / $77.34 / $138.72	Professional	26	$47.07	$77.34	$138.72
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $301.29 / $301.29 / $301.29	Professional	50	$301.29	$301.29	$301.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $118.56 / $305.91 / $569.77	Professional	TC	$118.56	$305.91	$569.77
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $603.28 / $603.28 / $603.28	Facility	26	$603.28	$603.28	$603.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $197.56 / $437.32 / $2,791.06	Professional		$197.56	$437.32	$2,791.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $54.76 / $67.05 / $525.38	Professional	26	$54.76	$67.05	$525.38
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $847.86 / $847.86 / $847.86	Professional	50	$847.86	$847.86	$847.86
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $138.66 / $349.22 / $2,451.15	Professional	TC	$138.66	$349.22	$2,451.15
United Facility/Professional Professional Modifier Low / Median / High Price $197.56 / $334.45 / $519.83	Professional		$197.56	$334.45	$519.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.76 / $59.05 / $122.40	Professional	26	$54.76	$59.05	$122.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.66 / $232.05 / $433.14	Professional	TC	$138.66	$232.05	$433.14