Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $30.90 / $52.48	Facility	26	$28.84	$30.90	$52.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $134.90 / $281.84	Professional		$95.50	$134.90	$281.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $48.98 / $91.20	Professional	26	$30.90	$48.98	$91.20
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $31.62 / $45.71 / $81.28	Professional	52	$31.62	$45.71	$81.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $95.50 / $177.83	Professional	TC	$75.86	$95.50	$177.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $97.72 / $162.18	Professional		$83.18	$97.72	$162.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $33.88 / $54.95	Professional	26	$26.92	$33.88	$54.95
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $23.99 / $23.99 / $32.36	Professional	52	$23.99	$23.99	$32.36
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $87.10 / $109.65	Professional	TC	$58.88	$87.10	$109.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $123.03 / $165.96	Professional		$36.31	$123.03	$165.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $56.23 / $56.23	Facility	26	$56.23	$56.23	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $131.83 / $213.80	Professional		$97.72	$131.83	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $38.02 / $63.10	Professional	26	$28.18	$38.02	$63.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $91.20 / $158.49	Professional	TC	$70.79	$91.20	$158.49
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $162.18 / $162.18	Facility	26	$85.11	$162.18	$162.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $154.88 / $831.76	Professional		$117.49	$154.88	$831.76
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $43.65 / $229.09	Professional	26	$33.11	$43.65	$229.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $109.65 / $602.56	Professional	TC	$85.11	$109.65	$602.56
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $138.04 / $194.98	Professional		$112.20	$138.04	$194.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $39.81 / $54.95	Professional	26	$32.36	$39.81	$54.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $100.00 / $144.54	Professional	TC	$81.28	$100.00	$144.54