Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.34 / $373.97 / $1,128.00	Facility		$113.34	$373.97	$1,128.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.91 / $40.19 / $67.31	Facility	26	$20.91	$40.19	$67.31
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $97.16 / $263.23 / $406.87	Facility	TC	$97.16	$263.23	$406.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.68 / $130.50 / $527.51	Professional		$26.68	$130.50	$527.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.03 / $25.55 / $101.00	Professional	26	$20.03	$25.55	$101.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.33 / $106.95 / $243.09	Professional	TC	$88.33	$106.95	$243.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.86 / $102.87 / $133.69	Professional		$83.86	$102.87	$133.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.79 / $23.93 / $38.50	Professional	26	$15.79	$23.93	$38.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $71.40 / $71.40 / $115.01	Professional	TC	$71.40	$71.40	$115.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $80.98 / $431.21 / $818.89	Facility		$80.98	$431.21	$818.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.89 / $118.52 / $148.15	Professional		$88.89	$118.52	$148.15
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.56 / $20.74 / $25.93	Professional	26	$15.56	$20.74	$25.93
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.33 / $97.78 / $122.22	Professional	TC	$73.33	$97.78	$122.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $224.43 / $273.56 / $332.91	Facility		$224.43	$273.56	$332.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.98 / $23.98 / $23.98	Facility	26	$23.98	$23.98	$23.98
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $109.98 / $109.98 / $109.98	Facility	TC	$109.98	$109.98	$109.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.04 / $171.46 / $266.66	Professional		$116.04	$171.46	$266.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.78 / $26.25 / $48.74	Professional	26	$20.78	$26.25	$48.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.66 / $145.36 / $219.42	Professional	TC	$95.66	$145.36	$219.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $108.41 / $153.50 / $267.45	Facility		$108.41	$153.50	$267.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $48.87 / $107.00 / $107.00	Facility	26	$48.87	$107.00	$107.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $195.28 / $442.03 / $442.03	Facility	TC	$195.28	$442.03	$442.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $111.74 / $176.77 / $1,052.95	Professional		$111.74	$176.77	$1,052.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.84 / $26.47 / $237.75	Professional	26	$19.84	$26.47	$237.75
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $91.27 / $149.96 / $927.48	Professional	TC	$91.27	$149.96	$927.48
United Facility/Professional Professional Modifier Low / Median / High Price $108.13 / $153.30 / $243.35	Professional		$108.13	$153.30	$243.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.53 / $24.10 / $48.03	Professional	26	$19.53	$24.10	$48.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.28 / $129.03 / $223.57	Professional	TC	$89.28	$129.03	$223.57