Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.88 / $76.58 / $269.93	Professional		$51.88	$76.58	$269.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.70 / $70.54 / $315.27	Professional	26	$31.70	$70.54	$315.27
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $24.58 / $24.92 / $35.97	Professional	52	$24.58	$24.92	$35.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.62 / $36.17 / $104.85	Professional	TC	$26.62	$36.17	$104.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.28 / $35.02 / $42.94	Professional		$32.28	$35.02	$42.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.87 / $16.91 / $35.67	Professional	26	$16.87	$16.91	$35.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.41 / $17.41 / $17.41	Professional	TC	$17.41	$17.41	$17.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.40 / $66.15 / $90.83	Professional		$36.40	$66.15	$90.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $157.50 / $157.50 / $157.50	Facility		$157.50	$157.50	$157.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.19 / $79.44 / $146.02	Professional		$33.19	$79.44	$146.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.26 / $39.29 / $87.00	Professional	26	$17.26	$39.29	$87.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.23 / $32.24 / $90.06	Professional	TC	$14.23	$32.24	$90.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $52.32 / $90.46 / $118.00	Facility		$52.32	$90.46	$118.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.88 / $83.05 / $547.54	Professional		$42.88	$83.05	$547.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $23.61 / $40.95 / $292.24	Professional	26	$23.61	$40.95	$292.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.27 / $61.28 / $349.50	Professional	TC	$19.27	$61.28	$349.50
United Facility/Professional Professional Modifier Low / Median / High Price $42.17 / $61.40 / $145.65	Professional		$42.17	$61.40	$145.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.61 / $36.42 / $63.43	Professional	26	$21.61	$36.42	$63.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.38 / $38.54 / $62.42	Professional	TC	$18.38	$38.54	$62.42