Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.88 / $72.53 / $121.62	Facility	26	$42.88	$72.53	$121.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.14 / $220.82 / $866.63	Professional		$172.14	$220.82	$866.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.30 / $38.46 / $121.00	Professional	26	$28.30	$38.46	$121.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $136.13 / $169.96 / $370.37	Professional	TC	$136.13	$169.96	$370.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.16 / $163.34 / $248.56	Professional		$139.16	$163.34	$248.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.30 / $32.59 / $50.02	Professional	26	$29.30	$32.59	$50.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $110.03 / $127.62 / $127.62	Professional	TC	$110.03	$127.62	$127.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.10 / $188.14 / $235.17	Professional		$141.10	$188.14	$235.17
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.09 / $37.45 / $46.81	Professional	26	$28.09	$37.45	$46.81
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $113.02 / $150.69 / $188.36	Professional	TC	$113.02	$150.69	$188.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.27 / $43.27 / $43.27	Facility	26	$43.27	$43.27	$43.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $187.59 / $267.81 / $429.80	Professional		$187.59	$267.81	$429.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.59 / $41.76 / $86.82	Professional	26	$29.59	$41.76	$86.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $149.97 / $222.29 / $344.46	Professional	TC	$149.97	$222.29	$344.46
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $87.82 / $210.00 / $210.00	Facility	26	$87.82	$210.00	$210.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $184.32 / $270.80 / $1,582.03	Professional		$184.32	$270.80	$1,582.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.26 / $41.81 / $422.69	Professional	26	$29.26	$41.81	$422.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $148.83 / $233.26 / $1,414.75	Professional	TC	$148.83	$233.26	$1,414.75
United Facility/Professional Professional Modifier Low / Median / High Price $177.29 / $243.72 / $405.06	Professional		$177.29	$243.72	$405.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.71 / $40.68 / $72.25	Professional	26	$28.71	$40.68	$72.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.32 / $210.00 / $331.65	Professional	TC	$144.32	$210.00	$331.65