Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.87 / $210.98 / $834.21	Facility		$113.87	$210.98	$834.21
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.57 / $22.62 / $26.48	Facility	26	$20.57	$22.62	$26.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.87 / $118.66 / $187.84	Professional		$113.87	$118.66	$187.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.57 / $21.00 / $26.48	Professional	26	$20.57	$21.00	$26.48
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $56.94 / $59.33 / $77.23	Professional	52	$56.94	$59.33	$77.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.29 / $98.44 / $164.30	Professional	TC	$93.29	$98.44	$164.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.47 / $96.47 / $113.50	Professional		$96.47	$96.47	$113.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.62 / $19.62 / $19.62	Professional	26	$19.62	$19.62	$19.62
BCBS Facility/Professional Facility Modifier Low / Median / High Price $243.14 / $326.52 / $472.99	Facility		$243.14	$326.52	$472.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.92 / $121.10 / $166.29	Professional		$21.92	$121.10	$166.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $101.18 / $108.85 / $227.36	Facility		$101.18	$108.85	$227.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.25 / $28.25 / $33.72	Facility	26	$28.25	$28.25	$33.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.66 / $169.95 / $224.26	Professional		$131.66	$169.95	$224.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.00 / $29.08 / $35.09	Professional	26	$22.00	$29.08	$35.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.90 / $139.19 / $195.57	Professional	TC	$108.90	$139.19	$195.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $113.87 / $168.30 / $299.12	Facility		$113.87	$168.30	$299.12
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 $121.48 / $184.48 / $1,173.20	Professional		$121.48	$184.48	$1,173.20
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.78 / $26.68 / $310.41	Professional	26	$19.78	$26.68	$310.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $97.65 / $171.73 / $1,048.79	Professional	TC	$97.65	$171.73	$1,048.79
United Facility/Professional Professional Modifier Low / Median / High Price $114.73 / $161.97 / $261.86	Professional		$114.73	$161.97	$261.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.78 / $24.94 / $45.78	Professional	26	$19.78	$24.94	$45.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.40 / $124.88 / $221.79	Professional	TC	$95.40	$124.88	$221.79