Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $489.60 / $489.60 / $489.60	Facility		$489.60	$489.60	$489.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $203.10 / $269.45 / $609.29	Professional		$203.10	$269.45	$609.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.31 / $77.92 / $116.45	Professional	26	$69.31	$77.92	$116.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.29 / $177.84 / $268.36	Professional	TC	$144.29	$177.84	$268.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.02 / $128.02 / $133.24	Professional		$128.02	$128.02	$133.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.97 / $37.19 / $96.11	Professional	26	$36.97	$37.19	$96.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $340.43 / $390.55 / $390.55	Professional		$340.43	$390.55	$390.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.86 / $279.56 / $562.38	Professional		$146.86	$279.56	$562.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.14 / $108.45 / $159.29	Professional	26	$42.14	$108.45	$159.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.91 / $197.51 / $403.09	Professional	TC	$104.91	$197.51	$403.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $191.35 / $287.33 / $368.35	Facility		$191.35	$287.33	$368.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $181.32 / $365.95 / $1,813.36	Professional		$181.32	$365.95	$1,813.36
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $78.31 / $112.26 / $509.36	Professional	26	$78.31	$112.26	$509.36
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $116.93 / $252.67 / $1,303.99	Professional	TC	$116.93	$252.67	$1,303.99
United Facility/Professional Professional Modifier Low / Median / High Price $180.82 / $279.17 / $372.02	Professional		$180.82	$279.17	$372.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.97 / $86.62 / $121.74	Professional	26	$51.97	$86.62	$121.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $116.93 / $186.92 / $253.34	Professional	TC	$116.93	$186.92	$253.34