Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $264.20 / $453.78 / $995.25	Facility		$264.20	$453.78	$995.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.00 / $71.25 / $119.67	Facility	26	$56.00	$71.25	$119.67
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $256.88 / $382.53 / $639.23	Facility	TC	$256.88	$382.53	$639.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.49 / $236.06 / $928.00	Professional		$178.49	$236.06	$928.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $36.68 / $172.00	Professional	26	$26.96	$36.68	$172.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $188.13 / $440.59	Professional	TC	$162.34	$188.13	$440.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $156.47 / $201.19 / $257.07	Professional		$156.47	$201.19	$257.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.02 / $35.10 / $68.30	Professional	26	$28.02	$35.10	$68.30
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $146.22 / $146.22 / $146.22	Professional	TC	$146.22	$146.22	$146.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $234.46 / $875.43 / $1,533.98	Facility		$234.46	$875.43	$1,533.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.77 / $237.02 / $296.27	Professional		$177.77	$237.02	$296.27
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.59 / $36.78 / $45.98	Professional	26	$27.59	$36.78	$45.98
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $150.18 / $200.24 / $250.30	Professional	TC	$150.18	$200.24	$250.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.22 / $607.07 / $717.25	Facility		$500.22	$607.07	$717.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.91 / $42.91 / $42.91	Facility	26	$42.91	$42.91	$42.91
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $227.42 / $227.42 / $227.42	Facility	TC	$227.42	$227.42	$227.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.60 / $337.06 / $546.20	Professional		$235.60	$337.06	$546.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.19 / $41.16 / $85.32	Professional	26	$29.19	$41.16	$85.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $198.92 / $290.35 / $463.03	Professional	TC	$198.92	$290.35	$463.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $214.60 / $284.06 / $473.60	Facility		$214.60	$284.06	$473.60
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $86.56 / $205.00 / $205.00	Facility	26	$86.56	$205.00	$205.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $399.93 / $906.68 / $906.68	Facility	TC	$399.93	$906.68	$906.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $229.44 / $333.80 / $1,952.19	Professional		$229.44	$333.80	$1,952.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $28.22 / $42.10 / $399.57	Professional	26	$28.22	$42.10	$399.57
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $196.83 / $302.39 / $1,791.16	Professional	TC	$196.83	$302.39	$1,791.16
United Facility/Professional Professional Modifier Low / Median / High Price $227.85 / $307.10 / $481.00	Professional		$227.85	$307.10	$481.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.89 / $39.96 / $70.34	Professional	26	$27.89	$39.96	$70.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $192.50 / $273.22 / $463.79	Professional	TC	$192.50	$273.22	$463.79