Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.35 / $564.30 / $1,073.59	Facility		$173.35	$564.30	$1,073.59
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.89 / $30.43 / $48.14	Facility	26	$21.89	$30.43	$48.14
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $99.00 / $281.83 / $932.60	Facility	TC	$99.00	$281.83	$932.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.84 / $130.50 / $263.27	Professional		$27.84	$130.50	$263.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.61 / $27.84 / $48.14	Professional	26	$20.61	$27.84	$48.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.83 / $118.00 / $216.52	Professional	TC	$90.83	$118.00	$216.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.62 / $83.62 / $87.50	Professional		$83.62	$83.62	$87.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.35 / $15.59 / $22.06	Professional	26	$15.35	$15.59	$22.06
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $68.27 / $72.54 / $110.94	Professional	TC	$68.27	$72.54	$110.94
BCBS Facility/Professional Facility Modifier Low / Median / High Price $344.00 / $456.72 / $761.25	Facility		$344.00	$456.72	$761.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.08 / $165.08 / $165.08	Professional		$165.08	$165.08	$165.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.15 / $146.36 / $455.25	Facility		$125.15	$146.36	$455.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.72 / $176.50 / $243.00	Professional		$111.72	$176.50	$243.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.41 / $31.72 / $45.01	Professional	26	$20.41	$31.72	$45.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.51 / $149.66 / $202.00	Professional	TC	$93.51	$149.66	$202.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $116.20 / $181.21 / $319.72	Facility		$116.20	$181.21	$319.72
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $48.87 / $48.87 / $107.00	Facility	26	$48.87	$48.87	$107.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $195.28 / $195.28 / $442.03	Facility	TC	$195.28	$195.28	$442.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $124.15 / $200.45 / $1,052.95	Professional		$124.15	$200.45	$1,052.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.74 / $30.77 / $237.75	Professional	26	$22.74	$30.77	$237.75
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $101.41 / $174.55 / $927.48	Professional	TC	$101.41	$174.55	$927.48
United Facility/Professional Professional Modifier Low / Median / High Price $124.15 / $170.68 / $295.02	Professional		$124.15	$170.68	$295.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.74 / $29.70 / $59.97	Professional	26	$22.74	$29.70	$59.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.25 / $135.38 / $238.23	Professional	TC	$100.25	$135.38	$238.23