Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.85 / $109.13 / $394.00	Professional		$85.85	$109.13	$394.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.40 / $37.76 / $134.40	Professional	26	$23.40	$37.76	$134.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.84 / $65.04 / $167.76	Professional	TC	$49.84	$65.04	$167.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.51 / $69.40 / $220.05	Professional		$58.51	$69.40	$220.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.45 / $21.05 / $38.86	Professional	26	$16.45	$21.05	$38.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $48.35 / $48.35 / $66.95	Professional	TC	$48.35	$48.35	$66.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.73 / $80.37 / $111.58	Professional		$46.73	$80.37	$111.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.04 / $23.31 / $39.34	Professional	26	$14.04	$23.31	$39.34
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.69 / $54.26 / $74.52	Professional	TC	$32.69	$54.26	$74.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.16 / $81.00 / $134.82	Professional		$50.16	$81.00	$134.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $36.32 / $54.48	Professional	26	$16.60	$36.32	$54.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.60 / $42.09 / $91.50	Professional	TC	$29.60	$42.09	$91.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $78.69 / $106.77 / $169.83	Facility		$78.69	$106.77	$169.83
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $170.73 / $170.73 / $170.73	Facility	26	$170.73	$170.73	$170.73
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $357.27 / $357.27 / $357.27	Facility	TC	$357.27	$357.27	$357.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.31 / $95.67 / $661.34	Professional		$57.31	$95.67	$661.34
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.09 / $38.52 / $278.39	Professional	26	$22.09	$38.52	$278.39
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $34.19 / $70.38 / $424.71	Professional	TC	$34.19	$70.38	$424.71
United Facility/Professional Professional Modifier Low / Median / High Price $57.31 / $64.31 / $144.71	Professional		$57.31	$64.31	$144.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.99 / $24.67 / $45.90	Professional	26	$21.99	$24.67	$45.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.19 / $45.23 / $90.68	Professional	TC	$34.19	$45.23	$90.68