Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.77 / $105.17 / $135.47	Facility	26	$96.77	$105.17	$135.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.19 / $229.24 / $320.25	Professional		$216.19	$229.24	$320.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.40 / $83.33 / $121.12	Professional	26	$80.40	$83.33	$121.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $118.17 / $148.83 / $199.13	Professional	TC	$118.17	$148.83	$199.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $303.45 / $303.45 / $303.45	Professional		$303.45	$303.45	$303.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $72.63 / $72.63 / $116.85	Professional	26	$72.63	$72.63	$116.85
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $116.00 / $116.00 / $116.00	Professional	TC	$116.00	$116.00	$116.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $307.23 / $307.23 / $307.23	Professional		$307.23	$307.23	$307.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.20 / $268.49 / $425.00	Professional		$173.20	$268.49	$425.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.73 / $104.85 / $204.00	Professional	26	$70.73	$104.85	$204.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $115.58 / $181.46 / $289.36	Professional	TC	$115.58	$181.46	$289.36
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $160.72 / $160.72 / $557.91	Facility	26	$160.72	$160.72	$557.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $187.73 / $284.89 / $1,677.02	Professional		$187.73	$284.89	$1,677.02
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $72.90 / $109.61 / $718.23	Professional	26	$72.90	$109.61	$718.23
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $111.60 / $175.74 / $985.97	Professional	TC	$111.60	$175.74	$985.97
United Facility/Professional Professional Modifier Low / Median / High Price $183.77 / $266.58 / $346.98	Professional		$183.77	$266.58	$346.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.59 / $99.44 / $137.28	Professional	26	$72.59	$99.44	$137.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $106.52 / $162.76 / $231.30	Professional	TC	$106.52	$162.76	$231.30