Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,326.09 / $5,326.09 / $7,290.00	Facility		$5,326.09	$5,326.09	$7,290.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.41 / $276.79 / $345.97	Facility	26	$114.41	$276.79	$345.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.78 / $211.53 / $341.62	Professional		$109.78	$211.53	$341.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.86 / $59.64 / $165.95	Professional	26	$48.86	$59.64	$165.95
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $54.89 / $76.58 / $126.08	Professional	52	$54.89	$76.58	$126.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.48 / $162.66 / $235.87	Professional	TC	$58.48	$162.66	$235.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.38 / $105.38 / $105.38	Professional		$105.38	$105.38	$105.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $49.97 / $57.66 / $64.58	Professional	26	$49.97	$57.66	$64.58
BCBS Facility/Professional Facility Modifier Low / Median / High Price $46.58 / $185.14 / $308.62	Facility		$46.58	$185.14	$308.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.79 / $124.33 / $157.35	Professional		$108.79	$124.33	$157.35
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.86 / $63.84 / $79.80	Professional	26	$55.86	$63.84	$79.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.93 / $60.49 / $75.61	Professional	TC	$52.93	$60.49	$75.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $568.38 / $6,496.35 / $8,686.52	Facility		$568.38	$6,496.35	$8,686.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.06 / $94.06 / $94.06	Facility	26	$94.06	$94.06	$94.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.94 / $250.53 / $549.47	Professional		$125.94	$250.53	$549.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.81 / $81.78 / $156.44	Professional	26	$55.81	$81.78	$156.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.36 / $144.24 / $451.99	Professional	TC	$57.36	$144.24	$451.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $140.50 / $212.88 / $793.59	Facility		$140.50	$212.88	$793.59
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $366.35 / $366.35 / $366.35	Facility	26	$366.35	$366.35	$366.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $165.77 / $288.89 / $3,102.49	Professional		$165.77	$288.89	$3,102.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $54.80 / $88.42 / $551.37	Professional	26	$54.80	$88.42	$551.37
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $78.67 / $171.90 / $2,808.09	Professional	TC	$78.67	$171.90	$2,808.09
United Facility/Professional Professional Modifier Low / Median / High Price $164.37 / $208.65 / $386.58	Professional		$164.37	$208.65	$386.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.12 / $83.14 / $129.85	Professional	26	$54.12	$83.14	$129.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.67 / $128.94 / $330.49	Professional	TC	$78.67	$128.94	$330.49