Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $162.18 / $676.08	Professional		$79.43	$162.18	$676.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $38.02 / $104.71	Professional	26	$22.91	$38.02	$104.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $66.07 / $446.68	Professional	TC	$48.98	$66.07	$446.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $102.33	Professional		$50.12	$50.12	$102.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $20.42 / $40.74	Professional	26	$15.85	$20.42	$40.74
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $34.67 / $69.18	Professional	TC	$34.67	$34.67	$69.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Professional		$117.49	$117.49	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $114.82 / $194.98	Professional		$51.29	$114.82	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $46.77 / $74.13	Professional	26	$18.20	$46.77	$74.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $67.61 / $125.89	Professional	TC	$33.88	$67.61	$125.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $114.82 / $151.36	Facility		$85.11	$114.82	$151.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $141.25 / $660.69	Professional		$70.79	$141.25	$660.69
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $47.86 / $275.42	Professional	26	$21.88	$47.86	$275.42
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $89.13 / $426.58	Professional	TC	$42.66	$89.13	$426.58
United Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $50.12 / $70.79	Facility		$21.38	$50.12	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $104.71 / $151.36	Professional		$64.57	$104.71	$151.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $40.74 / $52.48	Professional	26	$21.88	$40.74	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $67.61 / $97.72	Professional	TC	$42.66	$67.61	$97.72