Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.35 / $354.35 / $795.78	Facility		$98.35	$354.35	$795.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.23 / $32.10 / $44.04	Facility	26	$24.23	$32.10	$44.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.23 / $108.97 / $135.27	Professional		$97.23	$108.97	$135.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.07 / $28.84 / $47.24	Professional	26	$24.07	$28.84	$47.24
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $51.10 / $54.49 / $63.99	Professional	52	$51.10	$54.49	$63.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.37 / $83.28 / $112.00	Professional	TC	$78.37	$83.28	$112.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.79 / $77.79 / $167.62	Professional		$77.79	$77.79	$167.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.82 / $20.83 / $28.51	Professional	26	$19.82	$20.83	$28.51
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $57.95 / $57.95 / $94.17	Professional	TC	$57.95	$57.95	$94.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $344.00 / $456.72 / $761.25	Facility		$344.00	$456.72	$761.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $159.72 / $159.72 / $159.72	Professional		$159.72	$159.72	$159.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $129.65 / $148.31 / $455.25	Facility		$129.65	$148.31	$455.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.41 / $127.74 / $195.18	Professional		$81.41	$127.74	$195.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.63 / $35.26 / $48.74	Professional	26	$22.63	$35.26	$48.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.54 / $111.84 / $151.94	Professional	TC	$67.54	$111.84	$151.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $105.70 / $135.93 / $204.40	Facility		$105.70	$135.93	$204.40
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $63.16 / $122.00 / $122.00	Facility	26	$63.16	$122.00	$122.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.95 / $135.13 / $726.73	Professional		$100.95	$135.13	$726.73
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.05 / $35.39 / $255.92	Professional	26	$26.05	$35.39	$255.92
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $74.90 / $101.32 / $554.94	Professional	TC	$74.90	$101.32	$554.94
United Facility/Professional Facility Modifier Low / Median / High Price $114.42 / $209.50 / $214.74	Facility		$114.42	$209.50	$214.74
United Facility/Professional Professional Modifier Low / Median / High Price $100.95 / $123.22 / $191.40	Professional		$100.95	$123.22	$191.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.31 / $30.48 / $48.19	Professional	26	$27.31	$30.48	$48.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.90 / $91.31 / $151.54	Professional	TC	$74.90	$91.31	$151.54