Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $293.11 / $339.29 / $639.96	Professional		$293.11	$339.29	$639.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.51 / $131.38 / $295.60	Professional	26	$97.51	$131.38	$295.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $182.88 / $218.34 / $415.60	Professional	TC	$182.88	$218.34	$415.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.58 / $147.72 / $187.52	Professional	26	$65.58	$147.72	$187.52
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $204.72 / $204.72 / $204.72	Professional	TC	$204.72	$204.72	$204.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $183.85 / $294.14 / $330.92	Professional		$183.85	$294.14	$330.92
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.91 / $102.25 / $115.03	Professional	26	$63.91	$102.25	$115.03
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $119.94 / $191.90 / $215.89	Professional	TC	$119.94	$191.90	$215.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.33 / $241.87 / $550.21	Professional		$162.33	$241.87	$550.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.01 / $130.35 / $195.64	Professional	26	$67.01	$130.35	$195.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.33 / $150.24 / $371.08	Professional	TC	$77.33	$150.24	$371.08
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $632.78 / $632.78 / $632.78	Facility	26	$632.78	$632.78	$632.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $187.40 / $393.45 / $2,755.28	Professional		$187.40	$393.45	$2,755.28
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $81.13 / $152.66 / $895.79	Professional	26	$81.13	$152.66	$895.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $105.82 / $253.00 / $1,859.49	Professional	TC	$105.82	$253.00	$1,859.49
United Facility/Professional Professional Modifier Low / Median / High Price $179.42 / $264.93 / $470.43	Professional		$179.42	$264.93	$470.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.13 / $91.60 / $169.05	Professional	26	$81.13	$91.60	$169.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $105.82 / $176.74 / $342.90	Professional	TC	$105.82	$176.74	$342.90