Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $363.08 / $489.78	Facility		$173.78	$363.08	$489.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $67.61 / $81.28	Facility	26	$56.23	$67.61	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $141.25 / $407.38	Professional		$104.71	$141.25	$407.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $30.90 / $89.13	Professional	26	$20.89	$30.90	$89.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $107.15 / $234.42	Professional	TC	$85.11	$107.15	$234.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $91.20 / $154.88	Professional		$66.07	$91.20	$154.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $21.38 / $33.11	Professional	26	$16.98	$21.38	$33.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $416.87 / $630.96	Facility		$128.82	$416.87	$630.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $131.83 / $229.09	Professional		$117.49	$131.83	$229.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $25.70 / $44.67	Professional	26	$22.91	$25.70	$44.67
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $104.71 / $181.97	Professional	TC	$93.33	$104.71	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $275.42 / $346.74	Facility		$91.20	$275.42	$346.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.62 / $26.30 / $38.02	Facility	26	$5.62	$26.30	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $162.18 / $269.15	Professional		$114.82	$162.18	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $26.92 / $53.70	Professional	26	$20.42	$26.92	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $141.25 / $223.87	Professional	TC	$91.20	$141.25	$223.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $147.91 / $263.03	Facility		$107.15	$147.91	$263.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $104.71 / $104.71	Facility	26	$53.70	$104.71	$104.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $177.83 / $1,023.29	Professional		$112.20	$177.83	$1,023.29
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $28.18 / $218.78	Professional	26	$20.42	$28.18	$218.78
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $151.36 / $891.25	Professional	TC	$89.13	$151.36	$891.25
United Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $89.13 / $120.23	Facility		$19.05	$89.13	$120.23
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $154.88 / $234.42	Professional		$107.15	$154.88	$234.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $25.12 / $40.74	Professional	26	$20.42	$25.12	$40.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $131.83 / $194.98	Professional	TC	$85.11	$131.83	$194.98