Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.82 / $6.68 / $103.00	Professional	26	$5.82	$6.68	$103.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.14 / $22.57 / $108.87	Professional	TC	$20.14	$22.57	$108.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.02 / $21.02 / $22.19	Professional	26	$21.02	$21.02	$22.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.37 / $24.49 / $26.63	Professional	26	$18.37	$24.49	$26.63
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.50 / $76.66 / $83.37	Professional	TC	$57.50	$76.66	$83.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.97 / $31.71 / $57.96	Professional	26	$23.97	$31.71	$57.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.31 / $99.04 / $180.82	Professional	TC	$73.31	$99.04	$180.82
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $57.75 / $57.75 / $110.49	Facility	26	$57.75	$57.75	$110.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.25 / $149.40 / $149.40	Professional	26	$21.25	$149.40	$149.40
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $66.67 / $393.12 / $393.12	Professional	TC	$66.67	$393.12	$393.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.25 / $21.87 / $27.45	Professional	26	$21.25	$21.87	$27.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.67 / $66.67 / $97.79	Professional	TC	$66.67	$66.67	$97.79