Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.85 / $29.20 / $50.83	Facility	26	$28.85	$29.20	$50.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.18 / $122.13 / $147.29	Professional		$98.18	$122.13	$147.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.19 / $34.58 / $38.90	Professional	26	$29.19	$34.58	$38.90
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $31.17 / $31.17 / $36.90	Professional	52	$31.17	$31.17	$36.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.95 / $87.55 / $99.73	Professional	TC	$68.95	$87.55	$99.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.81 / $124.93 / $129.72	Professional		$90.81	$124.93	$129.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $33.71 / $83.23	Professional	26	$26.96	$33.71	$83.23
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $127.93 / $127.93 / $127.93	Professional	52	$127.93	$127.93	$127.93
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $103.75 / $103.75 / $134.40	Professional	TC	$103.75	$103.75	$134.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.40 / $121.80 / $167.25	Professional		$36.40	$121.80	$167.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.21 / $56.21 / $56.21	Facility	26	$56.21	$56.21	$56.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.30 / $121.00 / $187.75	Professional		$104.30	$121.00	$187.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.42 / $36.04 / $52.95	Professional	26	$29.42	$36.04	$52.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.89 / $84.14 / $134.32	Professional	TC	$74.89	$84.14	$134.32
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 $121.20 / $153.24 / $825.92	Professional		$121.20	$153.24	$825.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $33.44 / $43.27 / $227.63	Professional	26	$33.44	$43.27	$227.63
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $84.97 / $109.97 / $598.35	Professional	TC	$84.97	$109.97	$598.35
United Facility/Professional Professional Modifier Low / Median / High Price $118.41 / $139.31 / $204.66	Professional		$118.41	$139.31	$204.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.44 / $40.85 / $59.01	Professional	26	$33.44	$40.85	$59.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.95 / $99.97 / $149.96	Professional	TC	$83.95	$99.97	$149.96