Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $17.78 / $26.92	Facility	26	$14.45	$17.78	$26.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $93.33 / $181.97	Professional		$72.44	$93.33	$181.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $14.13 / $28.84	Professional	26	$10.96	$14.13	$28.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.84 / $28.84 / $93.33	Professional	52	$28.84	$28.84	$93.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $83.18 / $151.36	Professional	TC	$61.66	$83.18	$151.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $63.10 / $109.65	Professional		$54.95	$63.10	$109.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $9.77 / $15.85	Professional	26	$8.51	$9.77	$15.85
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $46.77 / $93.33	Professional	TC	$46.77	$46.77	$93.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Professional		$123.03	$123.03	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $112.20 / $194.98	Professional		$67.61	$112.20	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $16.60 / $32.36	Professional	26	$11.75	$16.60	$32.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $107.15 / $162.18	Professional	TC	$69.18	$107.15	$162.18
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $26.92 / $125.89	Facility	26	$26.92	$26.92	$125.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $138.04 / $776.25	Professional		$83.18	$138.04	$776.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $17.78 / $269.15	Professional	26	$12.88	$17.78	$269.15
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $125.89 / $691.83	Professional	TC	$74.13	$125.89	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $173.78	Professional		$87.10	$117.49	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $15.49 / $22.91	Professional	26	$12.88	$15.49	$22.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $100.00 / $158.49	Professional	TC	$74.13	$100.00	$158.49