Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.00 / $102.00 / $204.00	Facility		$102.00	$102.00	$204.00
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $102.00 / $102.00 / $102.00	Facility	TC	$102.00	$102.00	$102.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.95 / $40.08 / $81.70	Professional		$35.95	$40.08	$81.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.57 / $11.45 / $39.96	Professional	26	$9.57	$11.45	$39.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.38 / $30.77 / $69.87	Professional	TC	$26.38	$30.77	$69.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.97 / $18.97 / $19.82	Professional		$18.97	$18.97	$19.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.11 / $6.67 / $13.29	Professional	26	$5.11	$6.67	$13.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.03 / $66.67 / $66.67	Professional		$63.03	$66.67	$66.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.76 / $66.19 / $120.00	Professional		$21.76	$66.19	$120.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.78 / $15.07 / $46.00	Professional	26	$5.78	$15.07	$46.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.05 / $59.86 / $74.00	Professional	TC	$16.05	$59.86	$74.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.95 / $49.40 / $94.51	Facility		$35.95	$49.40	$94.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.72 / $58.60 / $360.92	Professional		$39.72	$58.60	$360.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.75 / $16.30 / $191.54	Professional	26	$10.75	$16.30	$191.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $47.89 / $268.14	Professional	TC	$28.18	$47.89	$268.14
United Facility/Professional Professional Modifier Low / Median / High Price $26.91 / $41.86 / $58.64	Professional		$26.91	$41.86	$58.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.15 / $11.76 / $16.67	Professional	26	$7.15	$11.76	$16.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.97 / $32.95 / $49.07	Professional	TC	$19.97	$32.95	$49.07