Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.39 / $43.10 / $66.92	Facility	26	$36.39	$43.10	$66.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.66 / $125.42 / $186.13	Professional		$121.66	$125.42	$186.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.71 / $41.34 / $61.50	Professional	26	$32.71	$41.34	$61.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $4.73 / $36.72 / $100.00	Professional	52	$4.73	$36.72	$100.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.28 / $92.01 / $123.92	Professional	TC	$83.28	$92.01	$123.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.64 / $95.53 / $211.92	Professional		$91.64	$95.53	$211.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.79 / $26.90 / $38.51	Professional	26	$26.79	$26.90	$38.51
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $68.90 / $105.38 / $105.38	Professional	TC	$68.90	$105.38	$105.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.44 / $146.44 / $146.44	Professional		$146.44	$146.44	$146.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.38 / $179.35 / $235.27	Professional		$102.38	$179.35	$235.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.28 / $51.68 / $68.31	Professional	26	$29.28	$51.68	$68.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.70 / $131.00 / $178.65	Professional	TC	$80.70	$131.00	$178.65
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $85.37 / $85.37 / $163.47	Facility	26	$85.37	$85.37	$163.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $137.47 / $164.36 / $825.92	Professional		$137.47	$164.36	$825.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.89 / $46.67 / $227.63	Professional	26	$38.89	$46.67	$227.63
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $97.80 / $117.93 / $598.35	Professional	TC	$97.80	$117.93	$598.35
United Facility/Professional Professional Modifier Low / Median / High Price $134.77 / $161.72 / $236.83	Professional		$134.77	$161.72	$236.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.89 / $44.83 / $66.66	Professional	26	$38.89	$44.83	$66.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.88 / $115.05 / $164.92	Professional	TC	$95.88	$115.05	$164.92