Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.04 / $278.69 / $737.17	Facility		$100.04	$278.69	$737.17
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.06 / $42.60 / $72.83	Facility	26	$35.06	$42.60	$72.83
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $84.12 / $234.32 / $700.00	Facility	TC	$84.12	$234.32	$700.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.26 / $119.64 / $158.32	Professional		$102.26	$119.64	$158.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.67 / $34.74 / $52.57	Professional	26	$31.67	$34.74	$52.57
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $50.48 / $53.34 / $62.82	Professional	52	$50.48	$53.34	$62.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.06 / $84.12 / $102.25	Professional	TC	$67.06	$84.12	$102.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.95 / $76.95 / $85.88	Professional		$76.95	$76.95	$85.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.80 / $25.94 / $37.09	Professional	26	$25.80	$25.94	$37.09
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $51.15 / $51.15 / $83.12	Professional	TC	$51.15	$51.15	$83.12
BCBS Facility/Professional Facility Modifier Low / Median / High Price $88.00 / $151.13 / $578.05	Facility		$88.00	$151.13	$578.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $175.50 / $175.50 / $175.50	Professional		$175.50	$175.50	$175.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $129.65 / $146.36 / $455.25	Facility		$129.65	$146.36	$455.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.74 / $142.79 / $211.00	Professional		$84.74	$142.79	$211.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.94 / $45.95 / $78.00	Professional	26	$28.94	$45.95	$78.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.86 / $96.83 / $137.41	Professional	TC	$55.86	$96.83	$137.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $103.48 / $144.49 / $229.54	Facility		$103.48	$144.49	$229.54
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $82.37 / $157.44 / $157.44	Facility	26	$82.37	$157.44	$157.44
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $155.00 / $331.53 / $1,075.86	Facility	TC	$155.00	$331.53	$1,075.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $114.93 / $139.55 / $704.47	Professional		$114.93	$139.55	$704.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.11 / $46.02 / $290.60	Professional	26	$35.11	$46.02	$290.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $77.26 / $100.23 / $483.33	Professional	TC	$77.26	$100.23	$483.33
United Facility/Professional Facility Modifier Low / Median / High Price $114.42 / $209.50 / $214.74	Facility		$114.42	$209.50	$214.74
United Facility/Professional Professional Modifier Low / Median / High Price $113.76 / $134.69 / $207.64	Professional		$113.76	$134.69	$207.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.65 / $41.60 / $75.22	Professional	26	$35.65	$41.60	$75.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.91 / $89.30 / $144.86	Professional	TC	$75.91	$89.30	$144.86