Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $165.96 / $229.09	Facility	26	$93.33	$165.96	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $239.88 / $645.65	Professional		$123.03	$239.88	$645.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $97.72 / $208.93	Professional	26	$42.66	$97.72	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $114.82 / $346.74	Professional	TC	$72.44	$114.82	$346.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $112.20 / $186.21	Professional		$95.50	$112.20	$186.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $46.77 / $75.86	Professional	26	$36.31	$46.77	$75.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $102.33 / $112.20	Professional	TC	$56.23	$102.33	$112.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $141.25 / $194.98	Professional		$114.82	$141.25	$194.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $44.67 / $72.44	Professional	26	$37.15	$44.67	$72.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $87.10 / $151.36	Professional	TC	$77.62	$87.10	$151.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $53.70 / $77.62	Facility	26	$11.48	$53.70	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $169.82 / $281.84	Professional		$114.82	$169.82	$281.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $56.23 / $100.00	Professional	26	$39.81	$56.23	$100.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $109.65 / $190.55	Professional	TC	$74.13	$109.65	$190.55
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $213.80 / $213.80	Facility	26	$112.20	$213.80	$213.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $158.49 / $870.96	Professional		$128.82	$158.49	$870.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $52.48 / $295.12	Professional	26	$45.71	$52.48	$295.12
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $104.71 / $575.44	Professional	TC	$87.10	$104.71	$575.44
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $144.54 / $223.87	Professional		$131.83	$144.54	$223.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $51.29 / $77.62	Professional	26	$45.71	$51.29	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $95.50 / $147.91	Professional	TC	$85.11	$95.50	$147.91