Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $213.80 / $549.54	Facility		$85.11	$213.80	$549.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.88 / $46.77 / $74.13	Facility	26	$33.88	$46.77	$74.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $89.13 / $199.53	Professional		$38.90	$89.13	$199.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $52.48 / $109.65	Professional	26	$30.20	$52.48	$109.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.98 / $120.23 / $281.84	Professional	50	$48.98	$120.23	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $56.23 / $93.33	Professional	TC	$43.65	$56.23	$93.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $66.07 / $131.83	Professional		$60.26	$66.07	$131.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $31.62 / $56.23	Professional	26	$23.99	$31.62	$56.23
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $81.28 / $93.33 / $199.53	Professional	50	$81.28	$93.33	$199.53
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $39.81 / $52.48	Professional	TC	$33.88	$39.81	$52.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $104.71 / $114.82	Facility		$48.98	$104.71	$114.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Professional		$120.23	$120.23	$120.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $112.20 / $194.98	Facility		$97.72	$112.20	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $93.33 / $165.96	Professional		$67.61	$93.33	$165.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $39.81 / $63.10	Professional	26	$27.54	$39.81	$63.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $64.57 / $102.33	Professional	TC	$43.65	$64.57	$102.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $104.71 / $229.09	Facility		$83.18	$104.71	$229.09
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $75.86 / $147.91	Facility	26	$75.86	$75.86	$147.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $107.15 / $549.54	Professional		$87.10	$107.15	$549.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $42.66 / $204.17	Professional	26	$33.88	$42.66	$204.17
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $64.57 / $338.84	Professional	TC	$52.48	$64.57	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $66.07 / $128.82	Facility		$54.95	$66.07	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $95.50 / $151.36	Professional		$87.10	$95.50	$151.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $38.02 / $58.88	Professional	26	$33.88	$38.02	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $57.54 / $93.33	Professional	TC	$52.48	$57.54	$93.33