Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.77 / $54.30 / $298.80	Facility	26	$51.77	$54.30	$298.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.94 / $120.09 / $194.27	Professional		$87.94	$120.09	$194.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.51 / $56.85 / $69.73	Professional	26	$46.51	$56.85	$69.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.43 / $54.63 / $144.61	Professional	TC	$41.43	$54.63	$144.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.31 / $90.31 / $90.31	Professional		$90.31	$90.31	$90.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.86 / $52.86 / $65.30	Professional	26	$52.86	$52.86	$65.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.84 / $126.35 / $173.50	Professional		$66.84	$126.35	$173.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.87 / $52.87 / $84.56	Facility	26	$52.87	$52.87	$84.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.37 / $165.67 / $320.20	Professional		$108.37	$165.67	$320.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.44 / $59.70 / $92.86	Professional	26	$47.44	$59.70	$92.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.67 / $92.56 / $207.92	Professional	TC	$48.67	$92.56	$207.92
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $155.03 / $302.75 / $302.75	Facility	26	$155.03	$302.75	$302.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $122.12 / $178.23 / $3,098.01	Professional		$122.12	$178.23	$3,098.01
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $54.09 / $68.23 / $636.41	Professional	26	$54.09	$68.23	$636.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $60.60 / $104.48 / $2,808.09	Professional	TC	$60.60	$104.48	$2,808.09
United Facility/Professional Professional Modifier Low / Median / High Price $120.25 / $152.79 / $374.45	Professional		$120.25	$152.79	$374.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.32 / $65.59 / $114.91	Professional	26	$53.32	$65.59	$114.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.60 / $83.51 / $319.11	Professional	TC	$60.60	$83.51	$319.11