Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.65 / $32.74 / $63.03	Facility	26	$27.65	$32.74	$63.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.77 / $65.09 / $96.70	Professional		$53.77	$65.09	$96.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.46 / $26.58 / $34.19	Professional	26	$23.46	$26.58	$34.19
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $26.62 / $27.89 / $32.86	Professional	52	$26.62	$27.89	$32.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.32 / $32.67 / $58.20	Professional	TC	$27.32	$32.67	$58.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.85 / $41.85 / $43.52	Professional		$41.85	$41.85	$43.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $20.14 / $28.96	Professional	26	$7.24	$20.14	$28.96
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $10.46 / $10.46 / $10.46	Professional	52	$10.46	$10.46	$10.46
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.07 / $23.07 / $23.07	Professional	TC	$23.07	$23.07	$23.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.00 / $114.00 / $114.00	Professional		$114.00	$114.00	$114.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.24 / $86.53 / $130.00	Professional		$46.24	$86.53	$130.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $34.39 / $47.55	Professional	26	$21.38	$34.39	$47.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.32 / $57.29 / $87.59	Professional	TC	$24.32	$57.29	$87.59
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $64.51 / $122.62 / $122.62	Facility	26	$64.51	$122.62	$122.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $80.48 / $96.83 / $447.95	Professional		$80.48	$96.83	$447.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.04 / $36.31 / $265.83	Professional	26	$26.04	$36.31	$265.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $50.89 / $63.15 / $398.99	Professional	TC	$50.89	$63.15	$398.99
United Facility/Professional Professional Modifier Low / Median / High Price $80.48 / $90.87 / $136.99	Professional		$80.48	$90.87	$136.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.51 / $31.66 / $48.18	Professional	26	$27.51	$31.66	$48.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.36 / $60.52 / $90.59	Professional	TC	$49.36	$60.52	$90.59