Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $616.60 / $1,412.54	Facility		$257.04	$616.60	$1,412.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $93.33 / $281.84	Facility	26	$32.36	$93.33	$281.84
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $151.36 / $371.54 / $537.03	Facility	TC	$151.36	$371.54	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $275.42 / $870.96	Professional		$169.82	$275.42	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $43.65 / $144.54	Professional	26	$30.20	$43.65	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $190.55 / $457.09	Professional	TC	$141.25	$190.55	$457.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $154.88 / $229.09	Professional		$120.23	$154.88	$229.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $30.90 / $60.26	Professional	26	$23.99	$30.90	$60.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $123.03 / $257.04	Professional	TC	$95.50	$123.03	$257.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $363.08 / $954.99	Facility		$169.82	$363.08	$954.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $204.17 / $363.08	Professional		$186.21	$204.17	$363.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $35.48 / $63.10	Professional	26	$32.36	$35.48	$63.10
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $173.78 / $295.12	Professional	TC	$151.36	$173.78	$295.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $575.44 / $724.44	Facility		$147.91	$575.44	$724.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $37.15 / $52.48	Facility	26	$7.94	$37.15	$52.48
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.48 / $165.96 / $234.42	Facility	TC	$35.48	$165.96	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $263.03 / $426.58	Professional		$181.97	$263.03	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $39.81 / $74.13	Professional	26	$30.90	$39.81	$74.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $218.78 / $354.81	Professional	TC	$151.36	$218.78	$354.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $239.88 / $645.65	Facility		$165.96	$239.88	$645.65
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $213.80 / $213.80	Facility	26	$75.86	$213.80	$213.80
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $309.03 / $691.83 / $691.83	Facility	TC	$309.03	$691.83	$691.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $275.42 / $1,584.89	Professional		$173.78	$275.42	$1,584.89
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $43.65 / $891.25	Professional	26	$30.20	$43.65	$891.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $234.42 / $1,380.38	Professional	TC	$144.54	$234.42	$1,380.38
United Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $134.90 / $181.97	Facility		$28.84	$134.90	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $239.88 / $371.54	Professional		$169.82	$239.88	$371.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $36.31 / $58.88	Professional	26	$29.51	$36.31	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $208.93 / $316.23	Professional	TC	$141.25	$208.93	$316.23