Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $120.23 / $323.59	Facility		$25.70	$120.23	$323.59
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.50 / $25.70 / $25.70	Facility	26	$19.50	$25.70	$25.70
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.05 / $281.84 / $331.13	Facility	TC	$19.05	$281.84	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $64.57 / $85.11	Professional		$30.20	$64.57	$85.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $21.88 / $45.71	Professional	26	$16.98	$21.88	$45.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $95.50 / $95.50 / $95.50	Professional	50	$95.50	$95.50	$95.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $38.90 / $38.90 / $43.65	Professional	52	$38.90	$38.90	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $18.20 / $57.54	Professional	TC	$12.88	$18.20	$57.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $33.11 / $45.71	Professional		$30.20	$33.11	$45.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $22.39 / $37.15	Professional	26	$19.05	$22.39	$37.15
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $7.76 / $10.23 / $10.47	Professional	52	$7.76	$10.23	$10.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $45.71 / $79.43	Professional		$33.11	$45.71	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $75.86 / $134.90	Professional		$33.88	$75.86	$134.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $30.20 / $60.26	Professional	26	$19.05	$30.20	$60.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $48.98 / $79.43	Professional	TC	$15.85	$48.98	$79.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $70.79 / $173.78	Facility		$29.51	$70.79	$173.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $47.86 / $100.00	Facility	26	$47.86	$47.86	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $52.48 / $52.48 / $141.25	Facility	TC	$52.48	$52.48	$141.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $79.43 / $398.11	Professional		$44.67	$79.43	$398.11
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $27.54 / $131.83	Professional	26	$21.88	$27.54	$131.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $54.95 / $281.84	Professional	TC	$22.91	$54.95	$281.84
United Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $54.95 / $245.47	Facility		$20.42	$54.95	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $58.88 / $97.72	Professional		$44.67	$58.88	$97.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $24.55 / $33.11	Professional	26	$21.88	$24.55	$33.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $30.20 / $60.26	Professional	TC	$22.91	$30.20	$60.26