Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $139.16 / $194.82 / $285.14	Facility	26	$139.16	$194.82	$285.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $554.14 / $761.38 / $1,254.18	Professional		$554.14	$761.38	$1,254.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.55 / $145.11 / $285.14	Professional	26	$112.55	$145.11	$285.14
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $277.07 / $365.50 / $708.64	Professional	52	$277.07	$365.50	$708.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $451.13 / $629.47 / $1,001.86	Professional	TC	$451.13	$629.47	$1,001.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $517.08 / $639.40 / $639.40	Professional		$517.08	$639.40	$639.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $100.76 / $100.76 / $124.60	Professional	26	$100.76	$100.76	$124.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,054.86 / $1,054.86 / $1,054.86	Professional		$1,054.86	$1,054.86	$1,054.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $575.96 / $913.65 / $1,388.15	Professional		$575.96	$913.65	$1,388.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $116.39 / $184.14 / $340.00	Professional	26	$116.39	$184.14	$340.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $458.63 / $730.69 / $1,138.08	Professional	TC	$458.63	$730.69	$1,138.08
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $275.57 / $275.57 / $275.57	Facility	26	$275.57	$275.57	$275.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $659.45 / $968.27 / $6,200.00	Professional		$659.45	$968.27	$6,200.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $135.50 / $210.57 / $2,600.00	Professional	26	$135.50	$210.57	$2,600.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $523.95 / $772.50 / $7,000.00	Professional	TC	$523.95	$772.50	$7,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $624.55 / $923.06 / $1,542.39	Professional		$624.55	$923.06	$1,542.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $128.25 / $198.00 / $297.36	Professional	26	$128.25	$198.00	$297.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $516.80 / $697.69 / $1,130.45	Professional	TC	$516.80	$697.69	$1,130.45