Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.25 / $91.28 / $153.72	Facility	26	$53.25	$91.28	$153.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.50 / $114.17 / $341.25	Professional		$87.50	$114.17	$341.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.50 / $34.93 / $97.85	Professional	26	$28.50	$34.93	$97.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.23 / $80.54 / $155.88	Professional	TC	$61.23	$80.54	$155.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.45 / $105.45 / $119.20	Professional		$105.45	$105.45	$119.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.00 / $51.02 / $70.70	Professional	26	$29.00	$51.02	$70.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.52 / $104.59 / $130.74	Professional		$91.52	$104.59	$130.74
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.50 / $30.28 / $40.04	Professional	26	$26.50	$30.28	$40.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $65.02 / $74.31 / $92.89	Professional	TC	$65.02	$74.31	$92.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.57 / $43.57 / $43.57	Facility	26	$43.57	$43.57	$43.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.98 / $131.09 / $227.20	Professional		$96.98	$131.09	$227.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.13 / $41.52 / $70.45	Professional	26	$30.13	$41.52	$70.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.30 / $89.57 / $162.97	Professional	TC	$65.30	$89.57	$162.97
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $172.60 / $172.60 / $172.60	Facility	26	$172.60	$172.60	$172.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.64 / $122.34 / $812.81	Professional		$100.64	$122.34	$812.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $33.36 / $41.50 / $240.49	Professional	26	$33.36	$41.50	$240.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $68.70 / $83.22 / $572.32	Professional	TC	$68.70	$83.22	$572.32
United Facility/Professional Professional Modifier Low / Median / High Price $97.92 / $122.34 / $195.85	Professional		$97.92	$122.34	$195.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.26 / $40.03 / $63.37	Professional	26	$32.26	$40.03	$63.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.98 / $80.84 / $132.47	Professional	TC	$66.98	$80.84	$132.47