Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.40 / $127.23 / $173.97	Facility	26	$106.40	$127.23	$173.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.03 / $230.67 / $286.74	Professional		$186.03	$230.67	$286.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.14 / $102.27 / $171.81	Professional	26	$76.14	$102.27	$171.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.71 / $128.97 / $181.12	Professional	TC	$100.71	$128.97	$181.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.90 / $134.34 / $287.89	Professional		$130.90	$134.34	$287.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.91 / $61.05 / $87.56	Professional	26	$60.91	$61.05	$87.56
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $73.43 / $119.31 / $119.31	Professional	TC	$73.43	$119.31	$119.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $436.04 / $436.04 / $436.04	Professional		$436.04	$436.04	$436.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.19 / $277.41 / $353.60	Professional		$166.19	$277.41	$353.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.31 / $117.07 / $155.33	Professional	26	$68.31	$117.07	$155.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.19 / $158.80 / $213.35	Professional	TC	$93.19	$158.80	$213.35
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $598.00 / $770.72 / $770.72	Facility	26	$598.00	$770.72	$770.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $205.17 / $272.56 / $1,217.23	Professional		$205.17	$272.56	$1,217.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $89.38 / $121.60 / $521.24	Professional	26	$89.38	$121.60	$521.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $116.81 / $154.21 / $1,308.00	Professional	TC	$116.81	$154.21	$1,308.00
United Facility/Professional Professional Modifier Low / Median / High Price $203.18 / $237.01 / $363.51	Professional		$203.18	$237.01	$363.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.14 / $102.67 / $153.84	Professional	26	$88.14	$102.67	$153.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $114.04 / $134.80 / $200.91	Professional	TC	$114.04	$134.80	$200.91