Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $228.60 / $228.60 / $744.00	Facility		$228.60	$228.60	$744.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.87 / $101.29 / $126.61	Facility	26	$41.87	$101.29	$126.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.57 / $90.20 / $173.71	Professional		$49.57	$90.20	$173.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.22 / $47.75 / $95.02	Professional	26	$28.22	$47.75	$95.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $82.23 / $165.74 / $179.00	Professional	50	$82.23	$165.74	$179.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $36.89 / $64.75	Professional	TC	$16.98	$36.89	$64.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.56 / $29.56 / $29.56	Professional		$29.56	$29.56	$29.56
BCBS Facility/Professional Facility Modifier Low / Median / High Price $12.21 / $48.02 / $79.87	Facility		$12.21	$48.02	$79.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.86 / $39.82 / $49.77	Professional		$29.86	$39.82	$49.77
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.97 / $23.96 / $29.95	Professional	26	$17.97	$23.96	$29.95
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $11.89 / $15.86 / $19.82	Professional	TC	$11.89	$15.86	$19.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.22 / $233.08 / $328.28	Facility		$117.22	$233.08	$328.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.29 / $34.29 / $34.29	Facility	26	$34.29	$34.29	$34.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.68 / $87.88 / $145.32	Professional		$41.68	$87.88	$145.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.53 / $46.68 / $71.48	Professional	26	$25.53	$46.68	$71.48
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $79.23 / $79.23 / $79.23	Professional	50	$79.23	$79.23	$79.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.19 / $38.24 / $69.27	Professional	TC	$15.19	$38.24	$69.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.47 / $71.91 / $176.12	Facility		$45.47	$71.91	$176.12
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $198.78 / $198.78 / $198.78	Facility	26	$198.78	$198.78	$198.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.64 / $93.81 / $659.45	Professional		$53.64	$93.81	$659.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.04 / $50.87 / $335.18	Professional	26	$32.04	$50.87	$335.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.60 / $40.50 / $404.98	Professional	TC	$21.60	$40.50	$404.98
United Facility/Professional Facility Modifier Low / Median / High Price $108.97 / $108.97 / $240.48	Facility		$108.97	$108.97	$240.48
United Facility/Professional Professional Modifier Low / Median / High Price $50.33 / $90.53 / $115.88	Professional		$50.33	$90.53	$115.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.50 / $48.33 / $68.76	Professional	26	$30.50	$48.33	$68.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.55 / $38.72 / $59.19	Professional	TC	$18.55	$38.72	$59.19