Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.17 / $63.64 / $122.97	Facility	26	$34.17	$63.64	$122.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.34 / $184.62 / $478.33	Professional		$113.34	$184.62	$478.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.75 / $48.58 / $142.00	Professional	26	$29.75	$48.58	$142.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $48.58 / $60.87 / $357.53	Professional	52	$48.58	$60.87	$357.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.59 / $98.15 / $219.00	Professional	TC	$83.59	$98.15	$219.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.59 / $89.35 / $116.16	Professional		$72.59	$89.35	$116.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.44 / $31.35 / $60.79	Professional	26	$24.44	$31.35	$60.79
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $21.90 / $21.90 / $59.46	Professional	52	$21.90	$21.90	$59.46
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $60.26 / $117.43	Professional	TC	$60.26	$60.26	$117.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.29 / $87.80 / $127.67	Professional		$68.29	$87.80	$127.67
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.11 / $34.81 / $43.51	Professional	26	$26.11	$34.81	$43.51
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.43 / $43.24 / $54.05	Professional	TC	$32.43	$43.24	$54.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.42 / $37.42 / $37.42	Facility	26	$37.42	$37.42	$37.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.72 / $138.50 / $235.79	Professional		$100.72	$138.50	$235.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.07 / $39.40 / $65.72	Professional	26	$28.07	$39.40	$65.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.64 / $95.45 / $170.07	Professional	TC	$72.64	$95.45	$170.07
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $148.36 / $148.36 / $148.36	Facility	26	$148.36	$148.36	$148.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $111.91 / $125.23 / $778.42	Professional		$111.91	$125.23	$778.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $33.54 / $36.28 / $290.60	Professional	26	$33.54	$36.28	$290.60
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $62.62 / $62.62 / $62.62	Professional	52	$62.62	$62.62	$62.62
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $82.48 / $89.86 / $570.15	Professional	TC	$82.48	$89.86	$570.15
United Facility/Professional Professional Modifier Low / Median / High Price $114.00 / $125.23 / $253.94	Professional		$114.00	$125.23	$253.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.07 / $35.36 / $57.83	Professional	26	$33.07	$35.36	$57.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.48 / $89.86 / $141.01	Professional	TC	$82.48	$89.86	$141.01