Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $234.42 / $323.59	Facility	26	$87.10	$234.42	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $363.08 / $1,258.93	Professional		$229.09	$363.08	$1,258.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $93.33 / $213.80	Professional	26	$60.26	$93.33	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $239.88 / $724.44	Professional	TC	$158.49	$239.88	$724.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $234.42 / $288.40	Professional		$162.18	$234.42	$288.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $60.26 / $123.03	Professional	26	$48.98	$60.26	$123.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $165.96 / $295.12	Professional	TC	$138.04	$165.96	$295.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $323.59 / $562.34	Professional		$251.19	$323.59	$562.34
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $74.13 / $131.83	Professional	26	$57.54	$74.13	$131.83
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $245.47 / $436.52	Professional	TC	$190.55	$245.47	$436.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.22 / $75.86 / $107.15	Facility	26	$16.22	$75.86	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $363.08 / $676.08	Professional		$218.78	$363.08	$676.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $77.62 / $141.25	Professional	26	$51.29	$77.62	$141.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $275.42 / $549.54	Professional	TC	$165.96	$275.42	$549.54
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $478.63 / $616.60 / $616.60	Facility	26	$478.63	$616.60	$616.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $398.11 / $2,398.83	Professional		$229.09	$398.11	$2,398.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $69.18 / $537.03	Professional	26	$57.54	$69.18	$537.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $316.23 / $2,630.27	Professional	TC	$169.82	$316.23	$2,630.27
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $354.81 / $549.54	Professional		$234.42	$354.81	$549.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $61.66 / $112.20	Professional	26	$57.54	$61.66	$112.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $281.84 / $457.09	Professional	TC	$173.78	$281.84	$457.09