Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.20 / $56.11 / $88.17	Facility	26	$47.20	$56.11	$88.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.88 / $154.52 / $187.04	Professional		$149.88	$154.52	$187.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.89 / $46.78 / $72.75	Professional	26	$42.89	$46.78	$72.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.51 / $111.43 / $148.69	Professional	TC	$104.51	$111.43	$148.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.23 / $117.94 / $261.83	Professional		$113.23	$117.94	$261.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.88 / $34.89 / $50.14	Professional	26	$34.88	$34.89	$50.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $83.25 / $108.22 / $127.32	Professional	TC	$83.25	$108.22	$127.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.07 / $190.07 / $190.07	Professional		$190.07	$190.07	$190.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.26 / $220.97 / $291.69	Professional		$127.26	$220.97	$291.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.46 / $68.03 / $88.94	Professional	26	$38.46	$68.03	$88.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.71 / $159.00 / $215.42	Professional	TC	$97.71	$159.00	$215.42
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $111.37 / $111.37 / $211.96	Facility	26	$111.37	$111.37	$211.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $170.30 / $203.69 / $1,024.30	Professional		$170.30	$203.69	$1,024.30
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $50.81 / $60.80 / $300.10	Professional	26	$50.81	$60.80	$300.10
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $117.91 / $142.19 / $724.19	Professional	TC	$117.91	$142.19	$724.19
United Facility/Professional Professional Modifier Low / Median / High Price $166.27 / $200.87 / $292.04	Professional		$166.27	$200.87	$292.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.67 / $59.52 / $87.13	Professional	26	$50.67	$59.52	$87.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $115.60 / $141.35 / $204.91	Professional	TC	$115.60	$141.35	$204.91