Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.47 / $343.00 / $622.04	Facility		$142.47	$343.00	$622.04
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.32 / $40.68 / $69.08	Facility	26	$32.32	$40.68	$69.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.82 / $182.97 / $665.00	Professional		$117.82	$182.97	$665.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.23 / $22.69 / $49.25	Professional	26	$19.23	$22.69	$49.25
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $58.91 / $66.90 / $357.34	Professional	52	$58.91	$66.90	$357.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.59 / $157.09 / $257.52	Professional	TC	$98.59	$157.09	$257.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.18 / $112.91 / $122.73	Professional		$98.18	$112.91	$122.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $20.04 / $28.06	Professional	26	$7.01	$20.04	$28.06
BCBS Facility/Professional Facility Modifier Low / Median / High Price $176.98 / $694.88 / $1,157.92	Facility		$176.98	$694.88	$1,157.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.60 / $130.13 / $162.66	Professional		$97.60	$130.13	$162.66
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.75 / $21.00 / $26.25	Professional	26	$15.75	$21.00	$26.25
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.84 / $109.13 / $136.41	Professional	TC	$81.84	$109.13	$136.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $317.14 / $372.33 / $446.68	Facility		$317.14	$372.33	$446.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.72 / $24.72 / $24.72	Facility	26	$24.72	$24.72	$24.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.58 / $186.04 / $285.99	Professional		$125.58	$186.04	$285.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.77 / $26.33 / $48.04	Professional	26	$20.77	$26.33	$48.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.35 / $160.94 / $246.27	Professional	TC	$104.35	$160.94	$246.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $119.18 / $167.97 / $285.27	Facility		$119.18	$167.97	$285.27
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $48.94 / $176.87 / $176.87	Facility	26	$48.94	$176.87	$176.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.42 / $190.38 / $1,173.20	Professional		$123.42	$190.38	$1,173.20
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.72 / $26.21 / $310.41	Professional	26	$19.72	$26.21	$310.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $102.63 / $164.83 / $1,048.79	Professional	TC	$102.63	$164.83	$1,048.79
United Facility/Professional Professional Modifier Low / Median / High Price $121.48 / $170.64 / $280.57	Professional		$121.48	$170.64	$280.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.53 / $23.94 / $45.25	Professional	26	$19.53	$23.94	$45.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.18 / $147.22 / $240.27	Professional	TC	$100.18	$147.22	$240.27