Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.63 / $70.06 / $146.97	Facility	26	$37.63	$70.06	$146.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.65 / $146.09 / $564.00	Professional		$119.65	$146.09	$564.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.24 / $37.63 / $97.91	Professional	26	$31.24	$37.63	$97.91
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $40.43 / $432.60 / $726.00	Professional	52	$40.43	$432.60	$726.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.00 / $99.73 / $219.36	Professional	TC	$81.00	$99.73	$219.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.57 / $112.09 / $129.72	Professional		$83.57	$112.09	$129.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.48 / $34.52 / $82.44	Professional	26	$27.48	$34.52	$82.44
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $20.83 / $25.29 / $126.71	Professional	52	$20.83	$25.29	$126.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $65.48 / $65.48 / $67.73	Professional	TC	$65.48	$65.48	$67.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.95 / $102.80 / $134.46	Professional		$89.95	$102.80	$134.46
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.36 / $25.55 / $35.13	Professional	26	$22.36	$25.55	$35.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.59 / $77.25 / $96.56	Professional	TC	$67.59	$77.25	$96.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.28 / $41.28 / $41.28	Facility	26	$41.28	$41.28	$41.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.45 / $167.36 / $266.06	Professional		$107.45	$167.36	$266.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.64 / $45.60 / $73.45	Professional	26	$30.64	$45.60	$73.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.80 / $119.56 / $194.03	Professional	TC	$76.80	$119.56	$194.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $85.37 / $163.47 / $163.47	Facility	26	$85.37	$163.47	$163.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $139.31 / $160.50 / $825.92	Professional		$139.31	$160.50	$825.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $39.31 / $43.77 / $227.63	Professional	26	$39.31	$43.77	$227.63
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $93.33 / $352.46 / $355.88	Professional	52	$93.33	$352.46	$355.88
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $100.80 / $116.73 / $598.35	Professional	TC	$100.80	$116.73	$598.35
United Facility/Professional Professional Modifier Low / Median / High Price $139.31 / $153.24 / $250.26	Professional		$139.31	$153.24	$250.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.29 / $43.27 / $73.95	Professional	26	$39.29	$43.27	$73.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $99.97 / $111.09 / $187.93	Professional	TC	$99.97	$111.09	$187.93