Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $156.58 / $216.74 / $451.99	Facility	26	$156.58	$216.74	$451.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $279.99 / $414.15 / $648.70	Professional		$279.99	$414.15	$648.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.64 / $121.89 / $272.13	Professional	26	$92.64	$121.89	$272.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.48 / $309.77 / $385.70	Professional	TC	$170.48	$309.77	$385.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $202.73 / $364.15 / $411.64	Professional		$202.73	$364.15	$411.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $86.74 / $129.24 / $207.32	Professional	26	$86.74	$129.24	$207.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $289.24 / $330.56 / $433.86	Professional		$289.24	$330.56	$433.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.55 / $111.48 / $139.35	Professional	26	$97.55	$111.48	$139.35
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $191.70 / $219.08 / $273.85	Professional	TC	$191.70	$219.08	$273.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.28 / $128.28 / $128.28	Facility	26	$128.28	$128.28	$128.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $319.00 / $587.38 / $952.64	Professional		$319.00	$587.38	$952.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.84 / $136.83 / $240.69	Professional	26	$80.84	$136.83	$240.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $224.22 / $430.94 / $721.23	Professional	TC	$224.22	$430.94	$721.23
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $1,048.24 / $1,048.24 / $1,048.24	Facility	26	$1,048.24	$1,048.24	$1,048.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $381.39 / $561.41 / $4,801.00	Professional		$381.39	$561.41	$4,801.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $98.89 / $116.66 / $1,632.94	Professional	26	$98.89	$116.66	$1,632.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $270.76 / $462.53 / $3,601.00	Professional	TC	$270.76	$462.53	$3,601.00
United Facility/Professional Professional Modifier Low / Median / High Price $366.67 / $499.60 / $848.14	Professional		$366.67	$499.60	$848.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $98.89 / $106.07 / $256.69	Professional	26	$98.89	$106.07	$256.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $263.89 / $395.83 / $653.22	Professional	TC	$263.89	$395.83	$653.22