Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.99 / $115.08 / $211.69	Professional		$99.99	$115.08	$211.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.15 / $39.72 / $62.71	Professional	26	$35.15	$39.72	$62.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.83 / $72.28 / $108.91	Professional	TC	$64.83	$72.28	$108.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.49 / $53.49 / $53.49	Professional		$53.49	$53.49	$53.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.63 / $18.82 / $63.10	Professional	26	$18.63	$18.82	$63.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.39 / $165.39 / $206.75	Professional		$165.39	$165.39	$206.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.83 / $166.77 / $229.78	Professional		$61.83	$166.77	$229.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.34 / $70.92 / $97.00	Professional	26	$27.34	$70.92	$97.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.32 / $89.21 / $148.97	Professional	TC	$40.32	$89.21	$148.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $99.99 / $134.99 / $178.35	Facility		$99.99	$134.99	$178.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $108.48 / $165.62 / $764.45	Professional		$108.48	$165.62	$764.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $57.84 / $310.87	Professional	26	$42.66	$57.84	$310.87
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $50.02 / $91.71 / $507.20	Professional	TC	$50.02	$91.71	$507.20
United Facility/Professional Professional Modifier Low / Median / High Price $76.44 / $123.45 / $172.49	Professional		$76.44	$123.45	$172.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.42 / $48.43 / $61.64	Professional	26	$26.42	$48.43	$61.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.02 / $81.96 / $108.38	Professional	TC	$50.02	$81.96	$108.38