Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $100.00 / $117.49	Facility	26	$72.44	$100.00	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $269.15 / $512.86	Professional		$79.43	$269.15	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $104.71 / $257.04	Professional	26	$60.26	$104.71	$257.04
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $190.55 / $190.55 / $190.55	Professional	52	$190.55	$190.55	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $223.87 / $436.52	Professional	TC	$141.25	$223.87	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $181.97 / $309.03	Professional		$151.36	$181.97	$309.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $61.66 / $102.33	Professional	26	$47.86	$61.66	$102.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $109.65 / $204.17	Professional	TC	$91.20	$109.65	$204.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $208.93 / $281.84	Professional		$64.57	$208.93	$281.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $61.66 / $100.00	Facility	26	$61.66	$61.66	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $398.11 / $602.56	Professional		$186.21	$398.11	$602.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $66.07 / $134.90	Professional	26	$53.70	$66.07	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $302.00 / $501.19	Professional	TC	$131.83	$302.00	$501.19
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 / $281.84 / $2,818.38	Professional		$199.53	$281.84	$2,818.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $74.13 / $524.81	Professional	26	$54.95	$74.13	$524.81
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $281.84 / $2,454.71	Professional	TC	$141.25	$281.84	$2,454.71
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $251.19 / $660.69	Professional		$199.53	$251.19	$660.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $69.18 / $104.71	Professional	26	$54.95	$69.18	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $169.82 / $588.84	Professional	TC	$138.04	$169.82	$588.84