Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $180.46 / $584.39 / $2,950.51	Facility		$180.46	$584.39	$2,950.51
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.78 / $131.40 / $273.02	Facility	26	$69.78	$131.40	$273.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.23 / $255.90 / $867.00	Professional		$186.23	$255.90	$867.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $73.93 / $261.31	Professional	26	$63.10	$73.93	$261.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $117.02 / $180.34 / $348.84	Professional	TC	$117.02	$180.34	$348.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $156.52 / $190.98 / $257.80	Professional		$156.52	$190.98	$257.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.78 / $64.73 / $90.62	Professional	26	$51.78	$64.73	$90.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $95.53 / $95.53 / $95.53	Professional	TC	$95.53	$95.53	$95.53
BCBS Facility/Professional Facility Modifier Low / Median / High Price $253.94 / $885.63 / $1,582.39	Facility		$253.94	$885.63	$1,582.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.04 / $194.72 / $243.40	Professional		$146.04	$194.72	$243.40
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.87 / $67.83 / $84.79	Professional	26	$50.87	$67.83	$84.79
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $95.17 / $126.89 / $158.61	Professional	TC	$95.17	$126.89	$158.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $219.59 / $219.59 / $2,274.26	Facility		$219.59	$219.59	$2,274.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.01 / $78.01 / $78.01	Facility	26	$78.01	$78.01	$78.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.04 / $285.79 / $444.07	Professional		$204.04	$285.79	$444.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.75 / $87.26 / $158.74	Professional	26	$66.75	$87.26	$158.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $133.02 / $201.15 / $301.73	Professional	TC	$133.02	$201.15	$301.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $180.46 / $248.05 / $474.79	Facility		$180.46	$248.05	$474.79
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $160.72 / $305.79 / $305.79	Facility	26	$160.72	$305.79	$305.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $192.90 / $280.97 / $3,949.29	Professional		$192.90	$280.97	$3,949.29
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $62.71 / $82.17 / $433.24	Professional	26	$62.71	$82.17	$433.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $124.74 / $195.47 / $1,005.74	Professional	TC	$124.74	$195.47	$1,005.74
United Facility/Professional Professional Modifier Low / Median / High Price $187.52 / $252.28 / $422.93	Professional		$187.52	$252.28	$422.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.20 / $76.97 / $143.29	Professional	26	$61.20	$76.97	$143.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $124.74 / $175.98 / $292.04	Professional	TC	$124.74	$175.98	$292.04