Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.84 / $67.45 / $129.38	Facility	26	$39.84	$67.45	$129.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.15 / $110.31 / $463.00	Professional		$93.15	$110.31	$463.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.13 / $36.22 / $80.58	Professional	26	$31.13	$36.22	$80.58
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $119.27 / $291.00 / $778.50	Professional	50	$119.27	$291.00	$778.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.67 / $70.84 / $136.61	Professional	TC	$63.67	$70.84	$136.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.68 / $85.16 / $102.40	Professional		$72.68	$85.16	$102.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.46 / $57.49 / $119.07	Professional	26	$26.46	$57.49	$119.07
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $100.08 / $127.75 / $151.16	Professional	50	$100.08	$127.75	$151.16
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $74.09 / $74.09 / $74.09	Professional	TC	$74.09	$74.09	$74.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.09 / $88.14 / $110.17	Professional		$66.09	$88.14	$110.17
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.71 / $27.61 / $34.51	Professional	26	$20.71	$27.61	$34.51
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.40 / $60.53 / $75.66	Professional	TC	$45.40	$60.53	$75.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.72 / $39.72 / $39.72	Facility	26	$39.72	$39.72	$39.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.89 / $128.09 / $203.42	Professional		$86.89	$128.09	$203.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.50 / $43.57 / $68.14	Professional	26	$29.50	$43.57	$68.14
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $138.68 / $138.68 / $138.68	Professional	50	$138.68	$138.68	$138.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.39 / $84.39 / $134.35	Professional	TC	$57.39	$84.39	$134.35
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $82.13 / $157.44 / $157.44	Facility	26	$82.13	$157.44	$157.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $103.97 / $114.76 / $667.61	Professional		$103.97	$114.76	$667.61
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.24 / $39.14 / $219.03	Professional	26	$35.24	$39.14	$219.03
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $109.96 / $150.97 / $241.55	Professional	50	$109.96	$150.97	$241.55
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $68.39 / $75.62 / $448.58	Professional	TC	$68.39	$75.62	$448.58
United Facility/Professional Professional Modifier Low / Median / High Price $104.11 / $110.36 / $199.86	Professional		$104.11	$110.36	$199.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.24 / $37.86 / $63.86	Professional	26	$35.24	$37.86	$63.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.42 / $72.14 / $120.59	Professional	TC	$68.42	$72.14	$120.59