Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.00 / $27.00 / $27.00	Facility	26	$27.00	$27.00	$27.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.23 / $102.05 / $114.50	Professional		$72.23	$102.05	$114.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.50 / $31.79 / $33.82	Professional	26	$22.50	$31.79	$33.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.73 / $70.09 / $80.68	Professional	TC	$49.73	$70.09	$80.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.72 / $41.72 / $52.36	Professional	26	$24.72	$41.72	$52.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.25 / $105.00 / $144.18	Professional		$33.25	$105.00	$144.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.07 / $53.07 / $53.07	Facility	26	$53.07	$53.07	$53.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.10 / $96.60 / $152.25	Professional		$83.10	$96.60	$152.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.76 / $32.79 / $49.96	Professional	26	$27.76	$32.79	$49.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.34 / $63.24 / $99.62	Professional	TC	$55.34	$63.24	$99.62
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $78.25 / $149.85 / $149.85	Facility	26	$78.25	$149.85	$149.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.87 / $115.98 / $730.62	Professional		$93.87	$115.98	$730.62
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.37 / $37.53 / $210.44	Professional	26	$30.37	$37.53	$210.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $61.92 / $78.45 / $520.19	Professional	TC	$61.92	$78.45	$520.19
United Facility/Professional Professional Modifier Low / Median / High Price $88.34 / $110.43 / $168.07	Professional		$88.34	$110.43	$168.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.37 / $35.36 / $57.17	Professional	26	$30.37	$35.36	$57.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.76 / $75.43 / $127.66	Professional	TC	$59.76	$75.43	$127.66