Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.51 / $159.07 / $307.67	Facility	26	$99.51	$159.07	$307.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $184.40 / $225.19 / $594.25	Professional		$184.40	$225.19	$594.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.44 / $91.97 / $302.64	Professional	26	$69.44	$91.97	$302.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.95 / $136.56 / $279.86	Professional	TC	$114.95	$136.56	$279.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.15 / $163.13 / $203.91	Professional		$139.15	$163.13	$203.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.37 / $94.94 / $135.56	Professional	26	$62.37	$94.94	$135.56
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $108.85 / $108.85 / $108.85	Professional	TC	$108.85	$108.85	$108.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.01 / $206.86 / $258.58	Professional		$181.01	$206.86	$258.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.79 / $81.83 / $102.29	Professional	26	$79.79	$81.83	$102.29
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $109.40 / $125.03 / $156.29	Professional	TC	$109.40	$125.03	$156.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.15 / $94.15 / $94.15	Facility	26	$94.15	$94.15	$94.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.76 / $248.74 / $425.02	Professional		$148.76	$248.74	$425.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.72 / $104.11 / $172.06	Professional	26	$59.72	$104.11	$172.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $86.52 / $144.57 / $245.43	Professional	TC	$86.52	$144.57	$245.43
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $770.72 / $770.72 / $770.72	Facility	26	$770.72	$770.72	$770.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $172.70 / $205.17 / $1,217.23	Professional		$172.70	$205.17	$1,217.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $71.43 / $86.20 / $521.24	Professional	26	$71.43	$86.20	$521.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $96.93 / $124.96 / $1,308.00	Professional	TC	$96.93	$124.96	$1,308.00
United Facility/Professional Professional Modifier Low / Median / High Price $172.70 / $202.68 / $382.19	Professional		$172.70	$202.68	$382.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.15 / $80.20 / $161.85	Professional	26	$71.15	$80.20	$161.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.93 / $121.61 / $221.14	Professional	TC	$96.93	$121.61	$221.14