Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $51.29 / $208.93	Facility	26	$30.20	$51.29	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $239.88 / $316.23	Professional		$177.83	$239.88	$316.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $38.02 / $91.20	Professional	26	$28.18	$38.02	$91.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $204.17 / $269.15	Professional	TC	$151.36	$204.17	$269.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $204.17 / $389.05	Professional		$199.53	$204.17	$389.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $41.69 / $48.98	Professional	26	$28.84	$41.69	$48.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $257.04 / $354.81	Professional		$40.74	$257.04	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $223.87 / $363.08	Professional		$147.91	$223.87	$363.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $35.48 / $57.54	Professional	26	$31.62	$35.48	$57.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $190.55 / $309.03	Professional	TC	$117.49	$190.55	$309.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $467.74 / $467.74	Facility	26	$87.10	$467.74	$467.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $288.40 / $2,398.83	Professional		$194.98	$288.40	$2,398.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $41.69 / $724.44	Professional	26	$31.62	$41.69	$724.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $229.09 / $1,659.59	Professional	TC	$154.88	$229.09	$1,659.59
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $245.47 / $371.54	Professional		$190.55	$245.47	$371.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $38.90 / $57.54	Professional	26	$30.90	$38.90	$57.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $213.80 / $323.59	Professional	TC	$154.88	$213.80	$323.59