Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.52 / $222.93 / $858.36	Facility		$94.52	$222.93	$858.36
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.03 / $34.04 / $52.86	Facility	26	$28.03	$34.04	$52.86
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $60.54 / $280.64 / $481.11	Facility	TC	$60.54	$280.64	$481.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.08 / $89.04 / $133.76	Professional		$83.08	$89.04	$133.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.04 / $29.64 / $52.77	Professional	26	$28.04	$29.64	$52.77
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $41.46 / $42.06 / $55.24	Professional	52	$41.46	$42.06	$55.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.04 / $60.32 / $99.56	Professional	TC	$55.04	$60.32	$99.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.44 / $95.55 / $119.44	Professional		$76.44	$95.55	$119.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.74 / $32.47 / $43.85	Professional	26	$25.74	$32.47	$43.85
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $67.01 / $67.01 / $78.84	Professional	TC	$67.01	$67.01	$78.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $183.47 / $246.40 / $356.94	Facility		$183.47	$246.40	$356.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.76 / $104.65 / $143.69	Professional		$35.76	$104.65	$143.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.56 / $93.97 / $171.30	Facility		$73.56	$93.97	$171.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.86 / $33.86 / $54.37	Facility	26	$33.86	$33.86	$54.37
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $74.01 / $74.01 / $98.51	Facility	TC	$74.01	$74.01	$98.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.77 / $105.82 / $171.08	Professional		$90.77	$105.82	$171.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.98 / $34.47 / $53.24	Professional	26	$28.98	$34.47	$53.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.43 / $72.81 / $113.28	Professional	TC	$58.43	$72.81	$113.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $84.95 / $148.15 / $294.00	Facility		$84.95	$148.15	$294.00
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 / $336.91	Facility	TC	$155.00	$331.53	$336.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $103.62 / $138.53 / $704.47	Professional		$103.62	$138.53	$704.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.65 / $39.75 / $290.60	Professional	26	$32.65	$39.75	$290.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $67.51 / $101.31 / $483.33	Professional	TC	$67.51	$101.31	$483.33
United Facility/Professional Facility Modifier Low / Median / High Price $439.68 / $439.68 / $439.68	Facility		$439.68	$439.68	$439.68
United Facility/Professional Professional Modifier Low / Median / High Price $97.86 / $120.89 / $181.44	Professional		$97.86	$120.89	$181.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.90 / $38.77 / $56.65	Professional	26	$31.90	$38.77	$56.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.95 / $81.48 / $121.50	Professional	TC	$65.95	$81.48	$121.50