Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $56.23 / $104.71	Facility	26	$44.67	$56.23	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $177.83 / $275.42	Professional		$131.83	$177.83	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $54.95 / $141.25	Professional	26	$40.74	$54.95	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $120.23 / $173.78	Professional	TC	$95.50	$120.23	$173.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $123.03 / $263.03	Professional		$112.20	$123.03	$263.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $38.02 / $70.79	Professional	26	$34.67	$38.02	$70.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $85.11 / $128.82	Professional	TC	$72.44	$85.11	$128.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $204.17 / $309.03	Professional		$125.89	$204.17	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $61.66 / $104.71	Professional	26	$39.81	$61.66	$104.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $147.91 / $269.15	Professional	TC	$93.33	$147.91	$269.15
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $112.20 / $213.80	Facility	26	$112.20	$112.20	$213.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $204.17 / $1,023.29	Professional		$165.96	$204.17	$1,023.29
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $60.26 / $302.00	Professional	26	$50.12	$60.26	$302.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $141.25 / $724.44	Professional	TC	$114.82	$141.25	$724.44
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $199.53 / $281.84	Professional		$165.96	$199.53	$281.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $58.88 / $85.11	Professional	26	$50.12	$58.88	$85.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $138.04 / $199.53	Professional	TC	$114.82	$138.04	$199.53