Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.43 / $133.88 / $159.49	Facility	26	$81.43	$133.88	$159.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.44 / $337.39 / $504.20	Professional		$81.44	$337.39	$504.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.44 / $136.76 / $192.84	Professional	26	$81.44	$136.76	$192.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $144.01 / $168.70 / $252.10	Professional	52	$144.01	$168.70	$252.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $198.26 / $296.24 / $475.74	Professional	TC	$198.26	$296.24	$475.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.55 / $153.77 / $341.21	Professional		$147.55	$153.77	$341.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.50 / $47.56 / $71.34	Professional	26	$47.50	$47.56	$71.34
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $138.19 / $162.59 / $162.59	Professional	TC	$138.19	$162.59	$162.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $458.03 / $458.03 / $458.03	Professional		$458.03	$458.03	$458.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.29 / $369.60 / $807.00	Professional		$170.29	$369.60	$807.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.10 / $84.41 / $173.00	Professional	26	$55.10	$84.41	$173.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.05 / $254.11 / $634.00	Professional	TC	$128.05	$254.11	$634.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $466.08 / $603.28 / $603.28	Facility	26	$466.08	$603.28	$603.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $237.09 / $503.56 / $2,791.06	Professional		$237.09	$503.56	$2,791.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $60.99 / $96.01 / $525.38	Professional	26	$60.99	$96.01	$525.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $167.09 / $442.57 / $2,451.15	Professional	TC	$167.09	$442.57	$2,451.15
United Facility/Professional Professional Modifier Low / Median / High Price $232.42 / $395.11 / $594.76	Professional		$232.42	$395.11	$594.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.99 / $76.30 / $131.96	Professional	26	$60.99	$76.30	$131.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.13 / $229.79 / $490.03	Professional	TC	$163.13	$229.79	$490.03