Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.34 / $228.30 / $761.80	Facility		$109.34	$228.30	$761.80
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.85 / $67.47 / $148.15	Facility	26	$39.85	$67.47	$148.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $82.72 / $174.55 / $401.44	Facility	TC	$82.72	$174.55	$401.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.43 / $145.78 / $587.92	Professional		$111.43	$145.78	$587.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.67 / $44.90 / $163.11	Professional	26	$31.67	$44.90	$163.11
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $44.66 / $55.72 / $328.05	Professional	52	$44.66	$55.72	$328.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.40 / $99.56 / $201.04	Professional	TC	$73.40	$99.56	$201.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.02 / $94.05 / $114.12	Professional		$80.02	$94.05	$114.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.47 / $26.99 / $61.52	Professional	26	$26.47	$26.99	$61.52
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.84 / $44.84 / $53.55	Professional	TC	$44.84	$44.84	$53.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.50 / $180.08 / $329.80	Facility		$50.50	$180.08	$329.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.90 / $93.20 / $116.50	Professional		$69.90	$93.20	$116.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.71 / $27.62 / $36.83	Professional	26	$20.71	$27.62	$36.83
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $49.19 / $65.58 / $81.98	Professional	TC	$49.19	$65.58	$81.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $224.43 / $290.33 / $396.46	Facility		$224.43	$290.33	$396.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.13 / $40.13 / $40.13	Facility	26	$40.13	$40.13	$40.13
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $82.40 / $82.40 / $82.40	Facility	TC	$82.40	$82.40	$82.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.40 / $140.28 / $222.68	Professional		$92.40	$140.28	$222.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $42.13 / $67.51	Professional	26	$29.51	$42.13	$67.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.56 / $99.08 / $151.59	Professional	TC	$62.56	$99.08	$151.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.23 / $137.85 / $249.51	Facility		$102.23	$137.85	$249.51
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $157.44 / $157.44 / $157.44	Facility	26	$157.44	$157.44	$157.44
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $331.53 / $331.53 / $331.53	Facility	TC	$331.53	$331.53	$331.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $110.81 / $136.15 / $704.47	Professional		$110.81	$136.15	$704.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.24 / $38.77 / $290.60	Professional	26	$35.24	$38.77	$290.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $75.56 / $99.35 / $483.33	Professional	TC	$75.56	$99.35	$483.33
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 $110.81 / $129.51 / $211.12	Professional		$110.81	$129.51	$211.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.24 / $37.59 / $62.40	Professional	26	$35.24	$37.59	$62.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.56 / $92.34 / $142.30	Professional	TC	$75.56	$92.34	$142.30