Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $146.30 / $172.12 / $255.41	Facility	26	$146.30	$172.12	$255.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.91 / $414.14 / $487.24	Professional		$282.91	$414.14	$487.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.37 / $138.00 / $173.21	Professional	26	$104.37	$138.00	$173.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $171.62 / $246.22 / $318.13	Professional	TC	$171.62	$246.22	$318.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $297.52 / $489.49 / $489.49	Professional		$297.52	$489.49	$489.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $82.91 / $83.99 / $119.19	Professional	26	$82.91	$83.99	$119.19
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $228.02 / $228.02 / $228.02	Professional	TC	$228.02	$228.02	$228.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $806.00 / $806.00 / $806.00	Professional		$806.00	$806.00	$806.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $317.37 / $622.89 / $1,092.00	Professional		$317.37	$622.89	$1,092.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.88 / $148.85 / $210.76	Professional	26	$95.88	$148.85	$210.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $240.55 / $446.75 / $894.00	Professional	TC	$240.55	$446.75	$894.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $815.92 / $1,048.24 / $1,048.24	Facility	26	$815.92	$1,048.24	$1,048.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $465.59 / $674.56 / $4,801.00	Professional		$465.59	$674.56	$4,801.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $110.10 / $165.03 / $1,632.94	Professional	26	$110.10	$165.03	$1,632.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $337.87 / $500.22 / $3,601.00	Professional	TC	$337.87	$500.22	$3,601.00
United Facility/Professional Professional Modifier Low / Median / High Price $450.76 / $610.32 / $935.26	Professional		$450.76	$610.32	$935.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $110.10 / $132.99 / $209.34	Professional	26	$110.10	$132.99	$209.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $329.86 / $461.80 / $689.35	Professional	TC	$329.86	$461.80	$689.35