Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.69 / $213.31 / $255.16	Facility	26	$131.69	$213.31	$255.16
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $173.76 / $173.76 / $329.53	Facility	53	$173.76	$173.76	$329.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $723.99 / $954.60 / $1,647.63	Professional		$723.99	$954.60	$1,647.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.75 / $162.72 / $255.16	Professional	26	$109.75	$162.72	$255.16
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $362.00 / $448.88 / $823.82	Professional	52	$362.00	$448.88	$823.82
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $144.80 / $179.55 / $329.53	Professional	53	$144.80	$179.55	$329.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $614.24 / $761.66 / $1,392.46	Professional	TC	$614.24	$761.66	$1,392.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $494.55 / $494.55 / $1,143.63	Professional		$494.55	$494.55	$1,143.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,261.69 / $1,261.69 / $1,261.69	Professional		$1,261.69	$1,261.69	$1,261.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $769.74 / $1,285.08 / $1,703.48	Professional		$769.74	$1,285.08	$1,703.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $116.22 / $228.83 / $359.75	Professional	26	$116.22	$228.83	$359.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $630.40 / $1,066.14 / $1,321.67	Professional	TC	$630.40	$1,066.14	$1,321.67
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $259.19 / $259.19 / $789.30	Facility	26	$259.19	$259.19	$789.30
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $281.39 / $281.39 / $643.30	Facility	53	$281.39	$281.39	$643.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $879.50 / $1,219.56 / $5,332.25	Professional		$879.50	$1,219.56	$5,332.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $132.09 / $226.16 / $1,044.83	Professional	26	$132.09	$226.16	$1,044.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $747.41 / $1,009.21 / $4,416.72	Professional	TC	$747.41	$1,009.21	$4,416.72
United Facility/Professional Professional Modifier Low / Median / High Price $879.50 / $1,103.84 / $1,654.41	Professional		$879.50	$1,103.84	$1,654.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $132.09 / $195.15 / $261.27	Professional	26	$132.09	$195.15	$261.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $747.41 / $895.97 / $1,284.47	Professional	TC	$747.41	$895.97	$1,284.47