Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.81 / $94.21 / $198.65	Facility	26	$68.81	$94.21	$198.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.94 / $138.84 / $355.05	Professional		$106.94	$138.84	$355.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $45.71 / $125.20	Professional	26	$29.91	$45.71	$125.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.52 / $99.05 / $238.97	Professional	TC	$78.52	$99.05	$238.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $148.93 / $148.93 / $148.93	Professional		$148.93	$148.93	$148.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.93 / $64.97 / $86.42	Professional	26	$36.93	$64.97	$86.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.24 / $130.56 / $163.19	Professional		$114.24	$130.56	$163.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.72 / $38.54 / $51.14	Professional	26	$33.72	$38.54	$51.14
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.51 / $92.01 / $115.01	Professional	TC	$80.51	$92.01	$115.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.98 / $55.98 / $55.98	Facility	26	$55.98	$55.98	$55.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.74 / $171.51 / $310.73	Professional		$123.74	$171.51	$310.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.71 / $44.68 / $74.18	Professional	26	$32.71	$44.68	$74.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.75 / $126.75 / $239.11	Professional	TC	$87.75	$126.75	$239.11
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $219.49 / $219.49 / $219.49	Facility	26	$219.49	$219.49	$219.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $133.03 / $159.30 / $1,019.78	Professional		$133.03	$159.30	$1,019.78
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $33.36 / $53.05 / $310.80	Professional	26	$33.36	$53.05	$310.80
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $99.31 / $119.32 / $708.98	Professional	TC	$99.31	$119.32	$708.98
United Facility/Professional Professional Modifier Low / Median / High Price $126.36 / $156.63 / $257.27	Professional		$126.36	$156.63	$257.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.22 / $49.48 / $74.22	Professional	26	$33.22	$49.48	$74.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.59 / $108.77 / $189.36	Professional	TC	$96.59	$108.77	$189.36