Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.39 / $296.83 / $697.55	Facility		$95.39	$296.83	$697.55
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.29 / $34.25 / $58.54	Facility	26	$28.29	$34.25	$58.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $68.26 / $233.11 / $560.00	Facility	TC	$68.26	$233.11	$560.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.06 / $96.70 / $127.74	Professional		$81.06	$96.70	$127.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $32.01 / $49.03	Professional	26	$25.26	$32.01	$49.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.75 / $68.26 / $86.65	Professional	TC	$51.75	$68.26	$86.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.01 / $62.01 / $75.08	Professional		$62.01	$62.01	$75.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.61 / $20.86 / $29.62	Professional	26	$20.61	$20.86	$29.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $41.40 / $44.71 / $67.28	Professional	TC	$41.40	$44.71	$67.28
BCBS Facility/Professional Facility Modifier Low / Median / High Price $64.00 / $130.62 / $487.28	Facility		$64.00	$130.62	$487.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.41 / $137.41 / $137.41	Professional		$137.41	$137.41	$137.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $119.68 / $146.36 / $455.25	Facility		$119.68	$146.36	$455.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.34 / $112.65 / $168.00	Professional		$68.34	$112.65	$168.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.06 / $36.50 / $64.00	Professional	26	$23.06	$36.50	$64.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.35 / $77.08 / $113.44	Professional	TC	$45.35	$77.08	$113.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $83.84 / $116.86 / $208.93	Facility		$83.84	$116.86	$208.93
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $65.77 / $125.66 / $125.66	Facility	26	$65.77	$125.66	$125.66
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $125.56 / $267.93 / $872.26	Facility	TC	$125.56	$267.93	$872.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $92.75 / $111.64 / $568.24	Professional		$92.75	$111.64	$568.24
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $28.33 / $36.72 / $227.85	Professional	26	$28.33	$36.72	$227.85
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $61.43 / $76.50 / $390.02	Professional	TC	$61.43	$76.50	$390.02
United Facility/Professional Facility Modifier Low / Median / High Price $114.42 / $209.50 / $242.28	Facility		$114.42	$209.50	$242.28
United Facility/Professional Professional Modifier Low / Median / High Price $91.65 / $102.03 / $170.60	Professional		$91.65	$102.03	$170.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.59 / $32.95 / $59.86	Professional	26	$28.59	$32.95	$59.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.86 / $71.37 / $115.37	Professional	TC	$60.86	$71.37	$115.37