Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.43 / $45.56 / $71.31	Facility	26	$38.43	$45.56	$71.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.04 / $122.60 / $153.52	Professional		$104.04	$122.60	$153.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.46 / $38.08 / $62.05	Professional	26	$34.46	$38.08	$62.05
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $73.78 / $108.74 / $147.55	Professional	52	$73.78	$108.74	$147.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.59 / $87.07 / $116.24	Professional	TC	$75.59	$87.07	$116.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.79 / $93.64 / $207.64	Professional		$89.79	$93.64	$207.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.32 / $28.66 / $40.71	Professional	26	$28.32	$28.66	$40.71
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $22.45 / $22.45 / $22.45	Professional	52	$22.45	$22.45	$22.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $84.91 / $99.89 / $99.89	Professional	TC	$84.91	$99.89	$99.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.15 / $154.15 / $154.15	Professional		$154.15	$154.15	$154.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.58 / $175.32 / $230.02	Professional		$100.58	$175.32	$230.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.94 / $54.76 / $72.19	Professional	26	$30.94	$54.76	$72.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.39 / $124.00 / $168.98	Professional	TC	$76.39	$124.00	$168.98
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $90.38 / $90.38 / $172.60	Facility	26	$90.38	$90.38	$172.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $134.74 / $160.57 / $810.58	Professional		$134.74	$160.57	$810.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $41.39 / $49.67 / $242.65	Professional	26	$41.39	$49.67	$242.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $92.49 / $111.54 / $567.92	Professional	TC	$92.49	$111.54	$567.92
United Facility/Professional Professional Modifier Low / Median / High Price $132.07 / $158.38 / $231.91	Professional		$132.07	$158.38	$231.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.39 / $47.89 / $83.34	Professional	26	$41.39	$47.89	$83.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.68 / $110.50 / $156.06	Professional	TC	$90.68	$110.50	$156.06