Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.31 / $214.23 / $540.74	Facility		$84.31	$214.23	$540.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.67 / $44.77 / $74.48	Facility	26	$32.67	$44.77	$74.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.36 / $83.67 / $131.50	Professional		$55.36	$83.67	$131.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.44 / $36.44 / $110.50	Professional	26	$30.44	$36.44	$110.50
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $92.15 / $92.15 / $147.86	Professional	50	$92.15	$92.15	$147.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.68 / $51.29 / $73.31	Professional	TC	$34.68	$51.29	$73.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.73 / $60.73 / $130.52	Professional		$60.73	$60.73	$130.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.02 / $24.76 / $34.52	Professional	26	$24.02	$24.76	$34.52
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $91.10 / $91.10 / $195.77	Professional	50	$91.10	$91.10	$195.77
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $39.01 / $59.66 / $59.66	Professional	TC	$39.01	$59.66	$59.66
BCBS Facility/Professional Facility Modifier Low / Median / High Price $49.00 / $90.19 / $209.96	Facility		$49.00	$90.19	$209.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.74 / $122.74 / $122.74	Professional		$122.74	$122.74	$122.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.46 / $117.62 / $241.75	Facility		$97.46	$117.62	$241.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.20 / $108.38 / $153.97	Professional		$66.20	$108.38	$153.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.47 / $42.82 / $60.73	Professional	26	$27.47	$42.82	$60.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.41 / $66.83 / $93.24	Professional	TC	$43.41	$66.83	$93.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $81.16 / $105.20 / $224.84	Facility		$81.16	$105.20	$224.84
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $76.50 / $76.50 / $146.86	Facility	26	$76.50	$76.50	$146.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.14 / $107.30 / $546.22	Professional		$89.14	$107.30	$546.22
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $34.65 / $42.49 / $203.94	Professional	26	$34.65	$42.49	$203.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $54.05 / $64.31 / $342.28	Professional	TC	$54.05	$64.31	$342.28
United Facility/Professional Facility Modifier Low / Median / High Price $84.95 / $173.16 / $210.24	Facility		$84.95	$173.16	$210.24
United Facility/Professional Professional Modifier Low / Median / High Price $87.76 / $98.05 / $154.59	Professional		$87.76	$98.05	$154.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.65 / $38.71 / $69.34	Professional	26	$34.65	$38.71	$69.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.31 / $59.93 / $94.63	Professional	TC	$53.31	$59.93	$94.63