Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $144.40 / $202.15 / $261.94	Facility	26	$144.40	$202.15	$261.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $581.88 / $821.91 / $1,311.53	Professional		$581.88	$821.91	$1,311.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $116.86 / $149.21 / $296.00	Professional	26	$116.86	$149.21	$296.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $290.94 / $382.39 / $741.05	Professional	52	$290.94	$382.39	$741.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $472.44 / $683.99 / $1,049.59	Professional	TC	$472.44	$683.99	$1,049.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $541.40 / $541.40 / $541.40	Professional		$541.40	$541.40	$541.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $104.91 / $129.72 / $129.72	Professional	26	$104.91	$129.72	$129.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,070.82 / $1,070.82 / $1,070.82	Professional		$1,070.82	$1,070.82	$1,070.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $603.82 / $957.45 / $1,453.76	Professional		$603.82	$957.45	$1,453.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $121.12 / $191.61 / $365.00	Professional	26	$121.12	$191.61	$365.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $482.07 / $765.83 / $1,193.48	Professional	TC	$482.07	$765.83	$1,193.48
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $286.83 / $286.83 / $286.83	Facility	26	$286.83	$286.83	$286.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $688.93 / $1,052.88 / $6,200.00	Professional		$688.93	$1,052.88	$6,200.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $140.61 / $226.56 / $1,081.48	Professional	26	$140.61	$226.56	$1,081.48
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $548.32 / $825.54 / $3,875.48	Professional	TC	$548.32	$825.54	$3,875.48
United Facility/Professional Professional Modifier Low / Median / High Price $655.92 / $974.12 / $1,544.46	Professional		$655.92	$974.12	$1,544.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $131.91 / $213.00 / $313.11	Professional	26	$131.91	$213.00	$313.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $527.16 / $745.00 / $1,172.20	Professional	TC	$527.16	$745.00	$1,172.20