Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $214.46 / $214.46 / $214.46	Facility	26	$214.46	$214.46	$214.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $665.72 / $978.40 / $4,275.00	Professional		$665.72	$978.40	$4,275.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.75 / $187.33 / $550.84	Professional	26	$102.75	$187.33	$550.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $316.98 / $390.85 / $521.13	Professional	52	$316.98	$390.85	$521.13
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $126.79 / $156.34 / $208.45	Professional	53	$126.79	$156.34	$208.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $543.24 / $767.25 / $1,175.16	Professional	TC	$543.24	$767.25	$1,175.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $693.38 / $693.38 / $693.38	Professional		$693.38	$693.38	$693.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $137.35 / $137.35 / $147.91	Professional	26	$137.35	$137.35	$147.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $556.96 / $636.53 / $795.66	Professional		$556.96	$636.53	$795.66
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.13 / $100.72 / $125.90	Professional	26	$88.13	$100.72	$125.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $468.83 / $535.80 / $669.76	Professional	TC	$468.83	$535.80	$669.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $126.71 / $126.71 / $126.71	Facility	26	$126.71	$126.71	$126.71
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $163.30 / $163.30 / $163.30	Facility	53	$163.30	$163.30	$163.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $731.22 / $1,061.90 / $1,953.83	Professional		$731.22	$1,061.90	$1,953.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.92 / $198.06 / $325.77	Professional	26	$109.92	$198.06	$325.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $621.29 / $895.12 / $1,609.90	Professional	TC	$621.29	$895.12	$1,609.90
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $259.19 / $789.30 / $789.30	Facility	26	$259.19	$789.30	$789.30
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $643.30 / $643.30 / $643.30	Facility	53	$643.30	$643.30	$643.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $804.21 / $1,065.97 / $5,332.25	Professional		$804.21	$1,065.97	$5,332.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $131.76 / $198.14 / $1,044.83	Professional	26	$131.76	$198.14	$1,044.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $661.57 / $880.87 / $4,416.72	Professional	TC	$661.57	$880.87	$4,416.72
United Facility/Professional Professional Modifier Low / Median / High Price $785.68 / $949.24 / $1,750.21	Professional		$785.68	$949.24	$1,750.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $117.13 / $181.26 / $294.81	Professional	26	$117.13	$181.26	$294.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $641.25 / $766.08 / $1,406.31	Professional	TC	$641.25	$766.08	$1,406.31