Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $251.67 / $275.74 / $500.75	Facility	26	$251.67	$275.74	$500.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $458.53 / $504.95 / $693.26	Professional		$458.53	$504.95	$693.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $198.28 / $226.87 / $275.74	Professional	26	$198.28	$226.87	$275.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.94 / $269.49 / $351.60	Professional	TC	$239.94	$269.49	$351.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $350.22 / $350.22 / $525.34	Professional		$350.22	$350.22	$525.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $214.96 / $246.40 / $356.86	Professional	26	$214.96	$246.40	$356.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $187.19 / $187.19 / $187.19	Professional	TC	$187.19	$187.19	$187.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,147.35 / $1,147.35 / $1,147.35	Professional		$1,147.35	$1,147.35	$1,147.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $438.43 / $716.98 / $1,981.00	Professional		$438.43	$716.98	$1,981.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $194.27 / $326.54 / $393.03	Professional	26	$194.27	$326.54	$393.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $247.38 / $381.97 / $1,605.00	Professional	TC	$247.38	$381.97	$1,605.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $528.44 / $528.44 / $528.44	Facility	26	$528.44	$528.44	$528.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $498.04 / $1,007.20 / $7,381.05	Professional		$498.04	$1,007.20	$7,381.05
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $232.42 / $305.05 / $1,699.00	Professional	26	$232.42	$305.05	$1,699.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $265.62 / $747.52 / $6,233.93	Professional	TC	$265.62	$747.52	$6,233.93
United Facility/Professional Professional Modifier Low / Median / High Price $484.14 / $733.68 / $1,455.34	Professional		$484.14	$733.68	$1,455.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $229.36 / $270.64 / $395.12	Professional	26	$229.36	$270.64	$395.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.64 / $399.22 / $1,242.97	Professional	TC	$257.64	$399.22	$1,242.97