Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.00 / $91.57 / $175.91	Facility	26	$66.00	$91.57	$175.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.55 / $194.53 / $616.65	Professional		$130.55	$194.53	$616.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $63.59 / $205.00	Professional	26	$42.60	$63.59	$205.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.67 / $99.56 / $214.93	Professional	TC	$84.67	$99.56	$214.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.09 / $117.16 / $159.19	Professional		$92.09	$117.16	$159.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.09 / $40.02 / $63.15	Professional	26	$36.09	$40.02	$63.15
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $61.68 / $61.68 / $120.20	Professional	TC	$61.68	$61.68	$120.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.86 / $122.88 / $171.23	Professional		$96.86	$122.88	$171.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.11 / $37.47 / $49.36	Professional	26	$28.11	$37.47	$49.36
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.63 / $78.18 / $97.72	Professional	TC	$58.63	$78.18	$97.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.96 / $53.96 / $53.96	Facility	26	$53.96	$53.96	$53.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.04 / $168.62 / $267.94	Professional		$114.04	$168.62	$267.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.04 / $55.79 / $93.74	Professional	26	$40.04	$55.79	$93.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.00 / $108.76 / $178.56	Professional	TC	$74.00	$108.76	$178.56
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $213.45 / $213.45 / $213.45	Facility	26	$213.45	$213.45	$213.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $138.26 / $157.16 / $872.98	Professional		$138.26	$157.16	$872.98
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $47.78 / $51.28 / $298.50	Professional	26	$47.78	$51.28	$298.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $90.48 / $104.16 / $574.48	Professional	TC	$90.48	$104.16	$574.48
United Facility/Professional Professional Modifier Low / Median / High Price $133.82 / $145.35 / $244.89	Professional		$133.82	$145.35	$244.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.41 / $50.89 / $82.60	Professional	26	$47.41	$50.89	$82.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.48 / $95.94 / $159.60	Professional	TC	$90.48	$95.94	$159.60