Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.11 / $116.25 / $172.38	Facility	26	$46.11	$116.25	$172.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.44 / $177.86 / $513.00	Professional		$93.44	$177.86	$513.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.61 / $53.09 / $211.20	Professional	26	$36.61	$53.09	$211.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.82 / $70.43 / $168.15	Professional	TC	$56.82	$70.43	$168.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.00 / $82.46 / $128.84	Professional		$67.00	$82.46	$128.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.55 / $30.76 / $53.83	Professional	26	$30.55	$30.76	$53.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $48.46 / $48.46 / $94.39	Professional	TC	$48.46	$48.46	$94.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.70 / $105.04 / $139.04	Professional		$81.70	$105.04	$139.04
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.96 / $31.94 / $39.93	Professional	26	$23.96	$31.94	$39.93
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.07 / $61.42 / $76.78	Professional	TC	$46.07	$61.42	$76.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.25 / $46.25 / $46.25	Facility	26	$46.25	$46.25	$46.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.07 / $126.73 / $217.59	Professional		$92.07	$126.73	$217.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.13 / $48.47 / $79.48	Professional	26	$34.13	$48.47	$79.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.94 / $77.87 / $139.87	Professional	TC	$57.94	$77.87	$139.87
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $181.68 / $181.68 / $181.68	Facility	26	$181.68	$181.68	$181.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $105.27 / $118.03 / $708.49	Professional		$105.27	$118.03	$708.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.65 / $44.61 / $257.68	Professional	26	$40.65	$44.61	$257.68
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $68.52 / $73.56 / $450.80	Professional	TC	$68.52	$73.56	$450.80
United Facility/Professional Professional Modifier Low / Median / High Price $107.71 / $115.13 / $197.79	Professional		$107.71	$115.13	$197.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.65 / $44.40 / $70.91	Professional	26	$40.65	$44.40	$70.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.52 / $72.22 / $113.99	Professional	TC	$68.52	$72.22	$113.99