Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $211.47 / $415.72 / $1,444.00	Facility		$211.47	$415.72	$1,444.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.71 / $66.79 / $97.53	Facility	26	$47.71	$66.79	$97.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.91 / $211.81 / $309.13	Professional		$144.91	$211.81	$309.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.76 / $58.72 / $89.16	Professional	26	$39.76	$58.72	$89.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $105.16 / $155.91 / $237.13	Professional	TC	$105.16	$155.91	$237.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $106.78 / $106.78 / $106.78	Professional		$106.78	$106.78	$106.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.42 / $41.32 / $41.32	Professional	26	$33.42	$41.32	$41.32
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $73.37 / $73.37 / $73.37	Professional	TC	$73.37	$73.37	$73.37
BCBS Facility/Professional Facility Modifier Low / Median / High Price $154.53 / $204.00 / $218.01	Facility		$154.53	$204.00	$218.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $221.47 / $221.47 / $221.47	Professional		$221.47	$221.47	$221.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $209.00 / $412.63 / $2,052.00	Facility		$209.00	$412.63	$2,052.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.80 / $250.47 / $360.76	Professional		$141.80	$250.47	$360.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.07 / $69.31 / $99.58	Professional	26	$40.07	$69.31	$99.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.90 / $185.01 / $240.21	Professional	TC	$102.90	$185.01	$240.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $137.78 / $262.83 / $469.21	Facility		$137.78	$262.83	$469.21
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $91.76 / $91.76 / $91.76	Facility	26	$91.76	$91.76	$91.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $181.52 / $271.33 / $1,023.12	Professional		$181.52	$271.33	$1,023.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $46.85 / $77.14 / $261.30	Professional	26	$46.85	$77.14	$261.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $132.63 / $193.64 / $767.60	Professional	TC	$132.63	$193.64	$767.60
United Facility/Professional Facility Modifier Low / Median / High Price $562.00 / $562.00 / $562.00	Facility		$562.00	$562.00	$562.00
United Facility/Professional Professional Modifier Low / Median / High Price $177.35 / $237.60 / $399.91	Professional		$177.35	$237.60	$399.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.72 / $68.22 / $103.87	Professional	26	$44.72	$68.22	$103.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $127.49 / $169.38 / $293.63	Professional	TC	$127.49	$169.38	$293.63