Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $398.11 / $724.44	Facility		$83.18	$398.11	$724.44
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $37.15 / $50.12	Facility	26	$25.70	$37.15	$50.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $85.11 / $208.93	Professional		$47.86	$85.11	$208.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $40.74 / $107.15	Professional	26	$26.30	$40.74	$107.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.98 / $104.71 / $588.84	Professional	50	$48.98	$104.71	$588.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $53.70 / $91.20	Professional	TC	$39.81	$53.70	$91.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $66.07 / $125.89	Professional		$60.26	$66.07	$125.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $30.20 / $51.29	Professional	26	$23.99	$30.20	$51.29
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $100.00 / $100.00 / $100.00	Professional	50	$100.00	$100.00	$100.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $45.71 / $77.62	Professional	TC	$39.81	$45.71	$77.62
BCBS Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $269.15 / $354.81	Facility		$181.97	$269.15	$354.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $81.28 / $112.20	Professional		$32.36	$81.28	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $323.59	Facility		$52.48	$52.48	$323.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $51.29 / $51.29	Facility	26	$51.29	$51.29	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $81.28 / $138.04	Professional		$63.10	$81.28	$138.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $32.36 / $53.70	Professional	26	$25.12	$32.36	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $50.12 / $85.11	Professional	TC	$38.02	$50.12	$85.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $109.65 / $295.12	Facility		$66.07	$109.65	$295.12
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 $75.86 / $97.72 / $549.54	Professional		$75.86	$97.72	$549.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $38.02 / $204.17	Professional	26	$29.51	$38.02	$204.17
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $58.88 / $338.84	Professional	TC	$45.71	$58.88	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $131.83 / $213.80	Facility		$38.02	$131.83	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $91.20 / $134.90	Professional		$70.79	$91.20	$134.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $36.31 / $52.48	Professional	26	$28.84	$36.31	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $54.95 / $81.28	Professional	TC	$43.65	$54.95	$81.28