Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.78 / $105.68 / $201.95	Professional		$94.78	$105.68	$201.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.37 / $26.02 / $58.03	Professional	26	$22.37	$26.02	$58.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.91 / $80.73 / $121.64	Professional	TC	$68.91	$80.73	$121.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $49.73 / $49.73 / $99.46	Professional		$49.73	$49.73	$99.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.95 / $12.05 / $30.11	Professional	26	$11.95	$12.05	$30.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.69 / $37.69 / $37.69	Professional	TC	$37.69	$37.69	$37.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.48 / $125.59 / $125.59	Professional		$93.48	$125.59	$125.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.52 / $117.12 / $190.11	Professional		$48.52	$117.12	$190.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.66 / $35.01 / $51.41	Professional	26	$13.66	$35.01	$51.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.04 / $85.56 / $134.35	Professional	TC	$35.04	$85.56	$134.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $52.57 / $113.64 / $146.94	Facility		$52.57	$113.64	$146.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.70 / $139.35 / $715.47	Professional		$77.70	$139.35	$715.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.03 / $36.52 / $162.69	Professional	26	$26.03	$36.52	$162.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $54.24 / $102.97 / $552.78	Professional	TC	$54.24	$102.97	$552.78
United Facility/Professional Professional Modifier Low / Median / High Price $77.70 / $104.46 / $144.24	Professional		$77.70	$104.46	$144.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.67 / $27.46 / $38.90	Professional	26	$16.67	$27.46	$38.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.02 / $78.43 / $103.22	Professional	TC	$48.02	$78.43	$103.22