Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $107.15 / $138.04	Facility		$48.98	$107.15	$138.04
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $31.62 / $31.62	Facility	26	$31.62	$31.62	$31.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $79.43 / $213.80	Professional		$38.90	$79.43	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $37.15 / $123.03	Professional	26	$28.18	$37.15	$123.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $54.95 / $120.23 / $331.13	Professional	50	$54.95	$120.23	$331.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $36.31 / $112.20	Professional	TC	$15.49	$36.31	$112.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $42.66 / $67.61	Professional		$38.02	$42.66	$67.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $27.54 / $33.88	Professional	26	$25.70	$27.54	$33.88
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $100.00 / $100.00 / $100.00	Professional	50	$100.00	$100.00	$100.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $16.22 / $22.91	Professional	TC	$13.80	$16.22	$22.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $151.36 / $229.09	Facility		$47.86	$151.36	$229.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $51.29 / $89.13	Professional		$45.71	$51.29	$89.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $32.36 / $56.23	Professional	26	$28.84	$32.36	$56.23
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $18.62 / $32.36	Professional	TC	$16.60	$18.62	$32.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $89.13 / $100.00	Facility		$70.79	$89.13	$100.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.24 / $33.88 / $47.86	Facility	26	$7.24	$33.88	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $85.11 / $144.54	Professional		$44.67	$85.11	$144.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $33.88 / $66.07	Professional	26	$25.70	$33.88	$66.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $51.29 / $83.18	Professional	TC	$15.85	$51.29	$83.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $67.61 / $151.36	Facility		$44.67	$67.61	$151.36
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $134.90 / $134.90	Facility	26	$69.18	$134.90	$134.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $91.20 / $457.09	Professional		$57.54	$91.20	$457.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $36.31 / $190.55	Professional	26	$26.30	$36.31	$190.55
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $54.95 / $316.23	Professional	TC	$27.54	$54.95	$316.23
United Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $52.48 / $83.18	Facility		$23.99	$52.48	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $79.43 / $117.49	Professional		$53.70	$79.43	$117.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $31.62 / $50.12	Professional	26	$25.70	$31.62	$50.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $48.98 / $74.13	Professional	TC	$22.39	$48.98	$74.13