Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.34 / $210.51 / $627.98	Facility		$113.34	$210.51	$627.98
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.65 / $51.90 / $115.17	Facility	26	$30.65	$51.90	$115.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.34 / $138.22 / $468.15	Professional		$107.34	$138.22	$468.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.07 / $36.79 / $142.00	Professional	26	$24.07	$36.79	$142.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $45.49 / $56.52 / $337.21	Professional	52	$45.49	$56.52	$337.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.75 / $99.30 / $472.75	Professional	TC	$81.75	$99.30	$472.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.78 / $88.15 / $108.89	Professional		$77.78	$88.15	$108.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.46 / $25.57 / $49.61	Professional	26	$20.46	$25.57	$49.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $50.79 / $50.79 / $97.68	Professional	TC	$50.79	$50.79	$97.68
BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.19 / $206.61 / $373.54	Facility		$57.19	$206.61	$373.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.64 / $95.52 / $119.40	Professional		$71.64	$95.52	$119.40
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.93 / $21.24 / $26.55	Professional	26	$15.93	$21.24	$26.55
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.71 / $74.28 / $92.85	Professional	TC	$55.71	$74.28	$92.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $224.43 / $290.33 / $361.16	Facility		$224.43	$290.33	$361.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.47 / $30.47 / $30.47	Facility	26	$30.47	$30.47	$30.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.36 / $127.12 / $225.24	Professional		$93.36	$127.12	$225.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.94 / $31.58 / $53.10	Professional	26	$22.94	$31.58	$53.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.42 / $94.55 / $172.23	Professional	TC	$70.42	$94.55	$172.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $94.67 / $124.44 / $237.36	Facility		$94.67	$124.44	$237.36
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $122.00 / $122.00 / $122.00	Facility	26	$122.00	$122.00	$122.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.64 / $118.79 / $726.73	Professional		$109.64	$118.79	$726.73
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $27.23 / $28.87 / $255.92	Professional	26	$27.23	$28.87	$255.92
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $81.87 / $90.08 / $554.94	Professional	TC	$81.87	$90.08	$554.94
United Facility/Professional Facility Modifier Low / Median / High Price $27.31 / $80.87 / $134.50	Facility		$27.31	$80.87	$134.50
United Facility/Professional Professional Modifier Low / Median / High Price $106.21 / $118.01 / $188.58	Professional		$106.21	$118.01	$188.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.22 / $28.80 / $47.20	Professional	26	$27.22	$28.80	$47.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.87 / $89.14 / $146.88	Professional	TC	$81.87	$89.14	$146.88