Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.70 / $108.04 / $207.40	Professional		$103.70	$108.04	$207.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.60 / $137.26 / $340.00	Professional	26	$50.60	$137.26	$340.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.11 / $58.89 / $90.83	Professional	TC	$58.11	$58.89	$90.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.44 / $77.06 / $83.68	Professional		$76.44	$77.06	$83.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.53 / $31.59 / $32.95	Professional	26	$31.53	$31.59	$32.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.59 / $144.19 / $198.01	Professional		$68.59	$144.19	$198.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.50 / $80.50 / $80.50	Facility		$80.50	$80.50	$80.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.74 / $131.93 / $272.22	Professional		$62.74	$131.93	$272.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.31 / $72.22 / $122.00	Professional	26	$32.31	$72.22	$122.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.43 / $44.91 / $165.75	Professional	TC	$30.43	$44.91	$165.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.00 / $142.35 / $221.69	Facility		$37.00	$142.35	$221.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $78.45 / $210.18 / $1,961.76	Professional		$78.45	$210.18	$1,961.76
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $42.86 / $88.78 / $434.05	Professional	26	$42.86	$88.78	$434.05
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $43.12 / $125.06 / $557.54	Professional	TC	$43.12	$125.06	$557.54
United Facility/Professional Professional Modifier Low / Median / High Price $78.45 / $157.35 / $247.41	Professional		$78.45	$157.35	$247.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.79 / $44.39 / $110.97	Professional	26	$39.79	$44.39	$110.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.65 / $50.02 / $125.06	Professional	TC	$38.65	$50.02	$125.06