Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.07 / $167.10 / $673.50	Facility		$82.07	$167.10	$673.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.81 / $53.87 / $119.53	Facility	26	$31.81	$53.87	$119.53
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $76.00 / $193.60 / $407.80	Facility	TC	$76.00	$193.60	$407.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.73 / $117.87 / $422.00	Professional		$89.73	$117.87	$422.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $35.36 / $131.21	Professional	26	$25.26	$35.36	$131.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.80 / $80.93 / $225.15	Professional	TC	$60.80	$80.93	$225.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.74 / $72.33 / $85.61	Professional		$61.74	$72.33	$85.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.23 / $32.13 / $49.17	Professional	26	$21.23	$32.13	$49.17
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $36.26 / $36.26 / $36.26	Professional	TC	$36.26	$36.26	$36.26
BCBS Facility/Professional Facility Modifier Low / Median / High Price $40.83 / $145.36 / $254.43	Facility		$40.83	$145.36	$254.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.30 / $75.06 / $93.84	Professional		$56.30	$75.06	$93.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.53 / $22.04 / $28.97	Professional	26	$16.53	$22.04	$28.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.77 / $53.03 / $66.29	Professional	TC	$39.77	$53.03	$66.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $217.87 / $272.37 / $332.03	Facility		$217.87	$272.37	$332.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.67 / $31.67 / $31.67	Facility	26	$31.67	$31.67	$31.67
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $66.73 / $66.73 / $66.73	Facility	TC	$66.73	$66.73	$66.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.98 / $111.84 / $177.83	Professional		$73.98	$111.84	$177.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.80 / $33.96 / $53.40	Professional	26	$23.80	$33.96	$53.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.33 / $76.59 / $123.11	Professional	TC	$50.33	$76.59	$123.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $82.32 / $112.69 / $206.54	Facility		$82.32	$112.69	$206.54
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $125.66 / $125.66 / $125.66	Facility	26	$125.66	$125.66	$125.66
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $267.93 / $267.93 / $267.93	Facility	TC	$267.93	$267.93	$267.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.80 / $108.81 / $568.24	Professional		$89.80	$108.81	$568.24
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $28.47 / $31.27 / $227.85	Professional	26	$28.47	$31.27	$227.85
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $61.33 / $77.54 / $390.02	Professional	TC	$61.33	$77.54	$390.02
United Facility/Professional Facility Modifier Low / Median / High Price $108.97 / $108.97 / $240.48	Facility		$108.97	$108.97	$240.48
United Facility/Professional Professional Modifier Low / Median / High Price $89.80 / $102.51 / $168.34	Professional		$89.80	$102.51	$168.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.47 / $30.24 / $59.75	Professional	26	$28.47	$30.24	$59.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.33 / $72.84 / $115.16	Professional	TC	$61.33	$72.84	$115.16