Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $204.17	Facility		$102.33	$102.33	$204.17
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $102.33 / $102.33 / $102.33	Facility	TC	$102.33	$102.33	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $64.57 / $151.36	Professional		$32.36	$64.57	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $16.98 / $54.95	Professional	26	$8.91	$16.98	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $46.77 / $64.57	Professional	TC	$22.91	$46.77	$64.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $19.05 / $37.15	Professional		$19.05	$19.05	$37.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.90 / $6.61 / $13.18	Professional	26	$4.90	$6.61	$13.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $27.54 / $27.54	Professional	TC	$27.54	$27.54	$27.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $66.07	Professional		$66.07	$66.07	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $51.29 / $120.23	Professional		$19.50	$51.29	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $13.49 / $45.71	Professional	26	$5.75	$13.49	$45.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $53.70 / $74.13	Professional	TC	$13.80	$53.70	$74.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $48.98 / $95.50	Facility		$36.31	$48.98	$95.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $58.88 / $363.08	Professional		$25.12	$58.88	$363.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $16.22 / $190.55	Professional	26	$7.08	$16.22	$190.55
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $47.86 / $269.15	Professional	TC	$17.78	$47.86	$269.15
United Facility/Professional Facility Modifier Low / Median / High Price $6.92 / $19.95 / $26.92	Facility		$6.92	$19.95	$26.92
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $54.95 / $61.66	Professional		$25.12	$54.95	$61.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $12.02 / $16.60	Professional	26	$7.08	$12.02	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $38.90 / $50.12	Professional	TC	$17.78	$38.90	$50.12