Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $33.88 / $56.23	Facility	26	$30.90	$33.88	$56.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $117.49 / $269.15	Professional		$58.88	$117.49	$269.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $44.67 / $95.50	Professional	26	$32.36	$44.67	$95.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $95.50 / $95.50 / $95.50	Professional	52	$95.50	$95.50	$95.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $89.13 / $158.49	Professional	TC	$70.79	$89.13	$158.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $97.72 / $162.18	Professional		$93.33	$97.72	$162.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $37.15 / $61.66	Professional	26	$28.84	$37.15	$61.66
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $64.57 / $75.86	Professional	TC	$56.23	$64.57	$75.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $120.23 / $162.18	Professional		$38.90	$120.23	$162.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $58.88 / $58.88	Facility	26	$58.88	$58.88	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $128.82 / $208.93	Professional		$95.50	$128.82	$208.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $39.81 / $67.61	Professional	26	$30.20	$39.81	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $87.10 / $147.91	Professional	TC	$67.61	$87.10	$147.91
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $173.78 / $173.78	Facility	26	$91.20	$173.78	$173.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $151.36 / $812.83	Professional		$114.82	$151.36	$812.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $45.71 / $239.88	Professional	26	$35.48	$45.71	$239.88
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $104.71 / $562.34	Professional	TC	$81.28	$104.71	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $134.90 / $190.55	Professional		$109.65	$134.90	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $41.69 / $58.88	Professional	26	$34.67	$41.69	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $95.50 / $134.90	Professional	TC	$75.86	$95.50	$134.90