Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.43 / $363.94 / $400.30	Facility		$38.43	$363.94	$400.30
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.47 / $21.47 / $25.82	Facility	26	$21.47	$21.47	$25.82
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.95 / $363.94 / $413.03	Facility	TC	$16.95	$363.94	$413.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.67 / $71.97 / $124.37	Professional		$35.67	$71.97	$124.37
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $71.59 / $71.59 / $71.59	Professional	25	$71.59	$71.59	$71.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.76 / $22.12 / $49.39	Professional	26	$17.76	$22.12	$49.39
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $234.74 / $234.74 / $435.00	Professional	50	$234.74	$234.74	$435.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.14 / $17.98 / $41.72	Professional	52	$14.14	$17.98	$41.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.49 / $53.22 / $80.70	Professional	TC	$14.49	$53.22	$80.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.94 / $34.94 / $34.94	Professional		$34.94	$34.94	$34.94
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.41 / $15.41 / $15.41	Professional	TC	$15.41	$15.41	$15.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.12 / $170.32 / $282.11	Facility		$43.12	$170.32	$282.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.87 / $35.28 / $44.10	Professional		$30.87	$35.28	$44.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.14 / $19.60 / $24.50	Professional	26	$17.14	$19.60	$24.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.72 / $15.68 / $19.60	Professional	TC	$13.72	$15.68	$19.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.38 / $41.38 / $41.38	Facility		$41.38	$41.38	$41.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.35 / $23.35 / $23.35	Facility	26	$23.35	$23.35	$23.35
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $18.64 / $18.64 / $18.64	Facility	TC	$18.64	$18.64	$18.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.82 / $74.93 / $124.61	Professional		$34.82	$74.93	$124.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.04 / $26.67 / $47.66	Professional	26	$19.04	$26.67	$47.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.16 / $49.11 / $74.50	Professional	TC	$15.16	$49.11	$74.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $34.94 / $51.44 / $146.68	Facility		$34.94	$51.44	$146.68
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $141.03 / $141.03 / $141.03	Facility	TC	$141.03	$141.03	$141.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.76 / $74.20 / $402.37	Professional		$43.76	$74.20	$402.37
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.73 / $25.76 / $130.60	Professional	26	$19.73	$25.76	$130.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.80 / $49.28 / $284.52	Professional	TC	$20.80	$49.28	$284.52
United Facility/Professional Professional Modifier Low / Median / High Price $43.14 / $65.52 / $103.17	Professional		$43.14	$65.52	$103.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.04 / $23.31 / $40.32	Professional	26	$19.04	$23.31	$40.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.75 / $43.68 / $68.40	Professional	TC	$20.75	$43.68	$68.40