Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.05 / $132.68 / $655.14	Professional		$77.05	$132.68	$655.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.32 / $56.62 / $466.05	Professional	26	$30.32	$56.62	$466.05
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $22.89 / $32.49 / $59.27	Professional	52	$22.89	$32.49	$59.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.57 / $75.09 / $600.79	Professional	TC	$31.57	$75.09	$600.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.17 / $44.41 / $82.00	Professional		$34.17	$44.41	$82.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $27.70 / $48.48	Professional	26	$16.98	$27.70	$48.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.91 / $21.91 / $33.71	Professional	TC	$21.91	$21.91	$33.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.33 / $53.88 / $75.45	Professional		$31.33	$53.88	$75.45
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.52 / $27.41 / $38.72	Professional	26	$16.52	$27.41	$38.72
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.81 / $24.58 / $33.77	Professional	TC	$14.81	$24.58	$33.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.82 / $70.05 / $108.08	Professional		$35.82	$70.05	$108.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.26 / $35.86 / $58.23	Professional	26	$17.26	$35.86	$58.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.82 / $35.71 / $64.93	Professional	TC	$16.82	$35.71	$64.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $66.84 / $85.86 / $143.58	Facility		$66.84	$85.86	$143.58
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $163.47 / $163.47 / $163.47	Facility	26	$163.47	$163.47	$163.47
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $216.27 / $216.27 / $216.27	Facility	TC	$216.27	$216.27	$216.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.88 / $70.87 / $547.54	Professional		$42.88	$70.87	$547.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.65 / $49.05 / $292.24	Professional	26	$21.65	$49.05	$292.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.27 / $39.79 / $349.50	Professional	TC	$19.27	$39.79	$349.50
United Facility/Professional Professional Modifier Low / Median / High Price $42.88 / $62.17 / $92.07	Professional		$42.88	$62.17	$92.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.61 / $23.61 / $46.55	Professional	26	$21.61	$23.61	$46.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.27 / $32.11 / $48.95	Professional	TC	$19.27	$32.11	$48.95