Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $151.36 / $426.58	Professional		$123.03	$151.36	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $74.13 / $363.08	Professional	26	$54.95	$74.13	$363.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $77.62 / $158.49	Professional	TC	$60.26	$77.62	$158.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $77.62 / $141.25	Professional		$74.13	$77.62	$141.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $40.74 / $107.15	Professional	26	$31.62	$40.74	$107.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $151.36 / $316.23	Professional		$74.13	$151.36	$316.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $83.18 / $134.90	Professional	26	$35.48	$83.18	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $81.28 / $177.83	Professional	TC	$38.90	$81.28	$177.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $162.18 / $213.80	Facility		$120.23	$162.18	$213.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $204.17 / $1,949.84	Professional		$95.50	$204.17	$1,949.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $95.50 / $436.52	Professional	26	$44.67	$95.50	$436.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $107.15 / $562.34	Professional	TC	$50.12	$107.15	$562.34
United Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $66.07 / $107.15	Facility		$42.66	$66.07	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $151.36 / $218.78	Professional		$95.50	$151.36	$218.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $74.13 / $104.71	Professional	26	$44.67	$74.13	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $79.43 / $117.49	Professional	TC	$50.12	$79.43	$117.49