Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.76 / $105.76 / $215.96	Facility	26	$105.76	$105.76	$215.96
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $138.22 / $138.22 / $138.22	Facility	53	$138.22	$138.22	$138.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $671.08 / $766.68 / $1,010.53	Professional		$671.08	$766.68	$1,010.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.76 / $113.20 / $206.06	Professional	26	$105.76	$113.20	$206.06
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $335.54 / $383.34 / $474.73	Professional	52	$335.54	$383.34	$474.73
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $134.22 / $153.34 / $189.89	Professional	53	$134.22	$153.34	$189.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $564.08 / $653.48 / $802.61	Professional	TC	$564.08	$653.48	$802.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $121.36 / $121.36 / $121.36	Professional	26	$121.36	$121.36	$121.36
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $598.17 / $598.17 / $598.17	Professional	TC	$598.17	$598.17	$598.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.51 / $792.75 / $1,088.56	Professional		$154.51	$792.75	$1,088.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $238.27 / $238.27 / $271.01	Facility	26	$238.27	$238.27	$271.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $752.03 / $1,065.72 / $1,305.08	Professional		$752.03	$1,065.72	$1,305.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $127.54 / $189.20 / $301.51	Professional	26	$127.54	$189.20	$301.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $588.04 / $843.41 / $1,025.33	Professional	TC	$588.04	$843.41	$1,025.33
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 $747.58 / $1,011.43 / $5,332.25	Professional		$747.58	$1,011.43	$5,332.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $114.92 / $208.81 / $1,044.83	Professional	26	$114.92	$208.81	$1,044.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $635.29 / $900.89 / $4,416.72	Professional	TC	$635.29	$900.89	$4,416.72
United Facility/Professional Professional Modifier Low / Median / High Price $729.99 / $942.02 / $1,657.96	Professional		$729.99	$942.02	$1,657.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $114.92 / $184.93 / $256.25	Professional	26	$114.92	$184.93	$256.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $600.46 / $784.78 / $1,390.77	Professional	TC	$600.46	$784.78	$1,390.77