Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.31 / $108.16 / $368.13	Facility		$49.31	$108.16	$368.13
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.31 / $31.31 / $31.31	Facility	26	$31.31	$31.31	$31.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.83 / $80.84 / $157.50	Professional		$44.83	$80.84	$157.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.33 / $32.47 / $79.14	Professional	26	$28.33	$32.47	$79.14
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $124.53 / $326.11 / $334.86	Professional	50	$124.53	$326.11	$334.86
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $20.41 / $25.11 / $167.43	Professional	52	$20.41	$25.11	$167.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.36 / $56.46 / $106.51	Professional	TC	$16.36	$56.46	$106.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.35 / $40.35 / $40.35	Professional		$40.35	$40.35	$40.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.62 / $25.62 / $25.62	Professional	26	$25.62	$25.62	$25.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.72 / $14.72 / $14.72	Professional	TC	$14.72	$14.72	$14.72
BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.50 / $186.48 / $310.74	Facility		$47.50	$186.48	$310.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.94 / $45.25 / $56.56	Professional		$33.94	$45.25	$56.56
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.46 / $28.61 / $35.76	Professional	26	$21.46	$28.61	$35.76
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.48 / $16.64 / $20.80	Professional	TC	$12.48	$16.64	$20.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.57 / $52.57 / $52.57	Facility		$52.57	$52.57	$52.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.84 / $33.84 / $33.84	Facility	26	$33.84	$33.84	$33.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.98 / $86.15 / $149.97	Professional		$43.98	$86.15	$149.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.42 / $34.72 / $67.95	Professional	26	$26.42	$34.72	$67.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.78 / $51.51 / $82.28	Professional	TC	$15.78	$51.51	$82.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.83 / $66.48 / $126.62	Facility		$44.83	$66.48	$126.62
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $68.52 / $134.74 / $134.74	Facility	26	$68.52	$134.74	$134.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.08 / $86.36 / $459.15	Professional		$58.08	$86.36	$459.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.41 / $33.67 / $188.73	Professional	26	$26.41	$33.67	$188.73
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.99 / $54.53 / $313.58	Professional	TC	$26.99	$54.53	$313.58
United Facility/Professional Professional Modifier Low / Median / High Price $56.32 / $79.80 / $126.00	Professional		$56.32	$79.80	$126.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.27 / $31.76 / $51.88	Professional	26	$26.27	$31.76	$51.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.52 / $48.65 / $72.59	Professional	TC	$25.52	$48.65	$72.59