Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $371.54 / $1,148.15	Professional		$275.42	$371.54	$1,148.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $269.15 / $776.25	Professional	26	$107.15	$269.15	$776.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $229.09 / $630.96	Professional	TC	$181.97	$229.09	$630.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $114.82 / $194.98	Professional	26	$112.20	$114.82	$194.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $204.17 / $204.17	Professional	TC	$204.17	$204.17	$204.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $302.00 / $416.87	Professional		$295.12	$302.00	$416.87
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $107.15 / $144.54	Professional	26	$102.33	$107.15	$144.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $199.53 / $275.42	Professional	TC	$190.55	$199.53	$275.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $263.03 / $549.54	Professional		$162.18	$263.03	$549.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $141.25 / $194.98	Professional	26	$67.61	$141.25	$194.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $158.49 / $371.54	Professional	TC	$77.62	$158.49	$371.54
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $630.96 / $630.96 / $630.96	Facility	26	$630.96	$630.96	$630.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $389.05 / $2,754.23	Professional		$186.21	$389.05	$2,754.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $151.36 / $891.25	Professional	26	$81.28	$151.36	$891.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $251.19 / $1,862.09	Professional	TC	$104.71	$251.19	$1,862.09
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $257.04 / $562.34	Professional		$177.83	$257.04	$562.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $91.20 / $194.98	Professional	26	$77.62	$91.20	$194.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $173.78 / $371.54	Professional	TC	$100.00	$173.78	$371.54