Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.06 / $402.72 / $946.39	Facility		$98.06	$402.72	$946.39
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.07 / $20.68 / $32.45	Facility	26	$20.07	$20.68	$32.45
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $86.57 / $250.55 / $873.09	Facility	TC	$86.57	$250.55	$873.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.65 / $111.03 / $157.80	Professional		$106.65	$111.03	$157.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.07 / $20.51 / $31.71	Professional	26	$20.07	$20.51	$31.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $86.56 / $91.34 / $127.15	Professional	TC	$86.56	$91.34	$127.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.89 / $117.40 / $124.19	Professional		$113.89	$117.40	$124.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.50 / $19.14 / $23.26	Professional	26	$15.50	$19.14	$23.26
BCBS Facility/Professional Facility Modifier Low / Median / High Price $305.02 / $409.64 / $593.36	Facility		$305.02	$409.64	$593.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.00 / $113.05 / $155.22	Professional		$21.00	$113.05	$155.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.97 / $98.20 / $206.86	Facility		$93.97	$98.20	$206.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.36 / $28.36 / $33.51	Facility	26	$28.36	$28.36	$33.51
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $157.38 / $157.38 / $173.35	Facility	TC	$157.38	$157.38	$173.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.04 / $156.55 / $220.99	Professional		$120.04	$156.55	$220.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.04 / $29.19 / $35.24	Professional	26	$22.04	$29.19	$35.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.56 / $127.55 / $190.18	Professional	TC	$97.56	$127.55	$190.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $106.66 / $158.19 / $316.80	Facility		$106.66	$158.19	$316.80
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 $109.55 / $161.09 / $1,052.95	Professional		$109.55	$161.09	$1,052.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.78 / $26.68 / $237.75	Professional	26	$19.78	$26.68	$237.75
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $87.68 / $155.16 / $927.48	Professional	TC	$87.68	$155.16	$927.48
United Facility/Professional Professional Modifier Low / Median / High Price $105.53 / $142.77 / $240.08	Professional		$105.53	$142.77	$240.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.32 / $23.88 / $40.77	Professional	26	$19.32	$23.88	$40.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $84.17 / $110.20 / $197.49	Professional	TC	$84.17	$110.20	$197.49