Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $223.87 / $371.54	Facility		$75.86	$223.87	$371.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $114.82 / $154.88	Facility	26	$37.15	$114.82	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $109.65 / $416.87	Professional		$58.88	$109.65	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $67.61 / $177.83	Professional	26	$30.20	$67.61	$177.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $67.61 / $199.53 / $645.65	Professional	50	$67.61	$199.53	$645.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $67.61 / $309.03	Professional	TC	$42.66	$67.61	$309.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $75.86 / $128.82	Professional		$60.26	$75.86	$128.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $30.90 / $60.26	Professional	26	$23.99	$30.90	$60.26
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $91.20 / $120.23 / $194.98	Professional	50	$91.20	$120.23	$194.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $39.81 / $89.13	Professional	TC	$32.36	$39.81	$89.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $89.13 / $173.78	Facility		$36.31	$89.13	$173.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $81.28 / $141.25	Professional		$72.44	$81.28	$141.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $28.84 / $51.29	Professional	26	$25.70	$28.84	$51.29
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $52.48 / $91.20	Professional	TC	$46.77	$52.48	$91.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $269.15 / $870.96	Facility		$131.83	$269.15	$870.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $37.15 / $52.48	Facility	26	$7.94	$37.15	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $107.15 / $173.78	Professional		$70.79	$107.15	$173.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $40.74 / $67.61	Professional	26	$27.54	$40.74	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $66.07 / $109.65	Professional	TC	$43.65	$66.07	$109.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $102.33 / $199.53	Facility		$79.43	$102.33	$199.53
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $147.91 / $147.91	Facility	26	$75.86	$147.91	$147.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $100.00 / $549.54	Professional		$81.28	$100.00	$549.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $38.02 / $204.17	Professional	26	$31.62	$38.02	$204.17
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $91.20 / $194.98 / $467.74	Professional	50	$91.20	$194.98	$467.74
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $60.26 / $338.84	Professional	TC	$51.29	$60.26	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $75.86 / $102.33	Facility		$39.81	$75.86	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $91.20 / $138.04	Professional		$81.28	$91.20	$138.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $35.48 / $54.95	Professional	26	$31.62	$35.48	$54.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $54.95 / $85.11	Professional	TC	$51.29	$54.95	$85.11