Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $129.40 / $188.94 / $252.65	Facility	26	$129.40	$188.94	$252.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $464.93 / $552.66 / $966.47	Professional		$464.93	$552.66	$966.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $166.51 / $252.65	Professional	26	$140.00	$166.51	$252.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $475.09 / $755.06	Professional	TC	$335.00	$475.09	$755.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $416.11 / $416.11 / $416.11	Professional		$416.11	$416.11	$416.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.59 / $75.59 / $108.68	Professional	26	$75.59	$75.59	$108.68
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $327.94 / $327.94 / $327.94	Professional	TC	$327.94	$327.94	$327.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $649.54 / $649.54 / $649.54	Professional		$649.54	$649.54	$649.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.63 / $655.04 / $1,586.00	Professional		$323.63	$655.04	$1,586.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.62 / $136.16 / $192.16	Professional	26	$85.62	$136.16	$192.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $270.08 / $512.60 / $1,408.00	Professional	TC	$270.08	$512.60	$1,408.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $745.12 / $953.92 / $953.92	Facility	26	$745.12	$953.92	$953.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $472.93 / $854.41 / $5,981.06	Professional		$472.93	$854.41	$5,981.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $97.58 / $144.69 / $883.52	Professional	26	$97.58	$144.69	$883.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $357.08 / $756.83 / $5,438.76	Professional	TC	$357.08	$756.83	$5,438.76
United Facility/Professional Professional Modifier Low / Median / High Price $458.34 / $757.22 / $1,215.38	Professional		$458.34	$757.22	$1,215.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.58 / $123.11 / $212.60	Professional	26	$97.58	$123.11	$212.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $348.63 / $587.00 / $999.62	Professional	TC	$348.63	$587.00	$999.62