Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $53.70 / $95.50	Facility	26	$33.11	$53.70	$95.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $91.20 / $218.78	Professional		$48.98	$91.20	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $43.65 / $95.50	Professional	26	$22.91	$43.65	$95.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $23.99 / $89.13	Professional	TC	$10.00	$23.99	$89.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $39.81 / $95.50	Professional		$34.67	$39.81	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $45.71 / $77.62	Professional	26	$38.90	$45.71	$77.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $6.76 / $8.51 / $12.88	Professional	TC	$6.76	$8.51	$12.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Professional		$158.49	$158.49	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $104.71 / $186.21	Professional		$45.71	$104.71	$186.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $39.81 / $74.13	Professional	26	$27.54	$39.81	$74.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.12 / $61.66 / $128.82	Professional	TC	$9.12	$61.66	$128.82
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $102.33 / $194.98	Facility	26	$102.33	$102.33	$194.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $125.89 / $562.34	Professional		$77.62	$125.89	$562.34
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $38.90 / $263.03	Professional	26	$30.90	$38.90	$263.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $93.33 / $426.58	Professional	TC	$44.67	$93.33	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $117.49 / $151.36	Professional		$77.62	$117.49	$151.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $34.67 / $53.70	Professional	26	$30.90	$34.67	$53.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $70.79 / $107.15	Professional	TC	$44.67	$70.79	$107.15