Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.89 / $66.65 / $71.55	Facility	26	$56.89	$66.65	$71.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.78 / $174.45 / $235.98	Professional		$148.78	$174.45	$235.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.89 / $61.61 / $83.33	Professional	26	$56.89	$61.61	$83.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.87 / $109.63 / $153.59	Professional	TC	$91.87	$109.63	$153.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.91 / $75.91 / $75.91	Professional	26	$75.91	$75.91	$75.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.59 / $179.90 / $247.03	Professional		$71.59	$179.90	$247.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.62 / $98.62 / $112.89	Facility	26	$98.62	$98.62	$112.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.06 / $243.97 / $318.88	Professional		$170.06	$243.97	$318.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.39 / $96.67 / $118.72	Professional	26	$73.39	$96.67	$118.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $106.60 / $149.07 / $200.16	Professional	TC	$106.60	$149.07	$200.16
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $160.72 / $557.91 / $557.91	Facility	26	$160.72	$557.91	$557.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $174.10 / $230.26 / $1,677.02	Professional		$174.10	$230.26	$1,677.02
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $63.42 / $90.45 / $718.23	Professional	26	$63.42	$90.45	$718.23
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $104.87 / $152.63 / $985.97	Professional	TC	$104.87	$152.63	$985.97
United Facility/Professional Professional Modifier Low / Median / High Price $164.42 / $206.51 / $311.39	Professional		$164.42	$206.51	$311.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.97 / $76.55 / $115.40	Professional	26	$61.97	$76.55	$115.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.87 / $136.74 / $216.97	Professional	TC	$104.87	$136.74	$216.97