Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.45 / $198.91 / $844.09	Facility		$107.45	$198.91	$844.09
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.70 / $73.98 / $162.44	Facility	26	$43.70	$73.98	$162.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.85 / $170.74 / $612.00	Professional		$116.85	$170.74	$612.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $49.12 / $183.00	Professional	26	$34.67	$49.12	$183.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.00 / $100.06 / $437.00	Professional	TC	$78.00	$100.06	$437.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.68 / $93.11 / $113.92	Professional		$76.68	$93.11	$113.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.02 / $36.45 / $70.73	Professional	26	$29.02	$36.45	$70.73
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $47.51 / $54.82 / $91.36	Professional	TC	$47.51	$54.82	$91.36
BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.50 / $190.71 / $333.35	Facility		$53.50	$190.71	$333.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.81 / $99.76 / $124.70	Professional		$74.81	$99.76	$124.70
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.71 / $30.28 / $40.04	Professional	26	$22.71	$30.28	$40.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.11 / $69.48 / $86.85	Professional	TC	$52.11	$69.48	$86.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $224.43 / $290.33 / $409.32	Facility		$224.43	$290.33	$409.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.62 / $43.62 / $43.62	Facility	26	$43.62	$43.62	$43.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.07 / $149.56 / $242.41	Professional		$98.07	$149.56	$242.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $46.19 / $75.76	Professional	26	$32.36	$46.19	$75.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.70 / $100.72 / $160.27	Professional	TC	$65.70	$100.72	$160.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $109.54 / $147.07 / $264.79	Facility		$109.54	$147.07	$264.79
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $172.60 / $172.60 / $172.60	Facility	26	$172.60	$172.60	$172.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $118.94 / $144.01 / $760.68	Professional		$118.94	$144.01	$760.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.63 / $42.53 / $303.79	Professional	26	$38.63	$42.53	$303.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $80.31 / $102.96 / $518.02	Professional	TC	$80.31	$102.96	$518.02
United Facility/Professional Professional Modifier Low / Median / High Price $118.94 / $135.97 / $225.55	Professional		$118.94	$135.97	$225.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.63 / $41.86 / $73.44	Professional	26	$38.63	$41.86	$73.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.31 / $93.65 / $152.88	Professional	TC	$80.31	$93.65	$152.88