Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $204.17 / $295.12	Facility	26	$162.18	$204.17	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $724.44 / $1,288.25	Professional		$575.44	$724.44	$1,288.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $147.91 / $316.23	Professional	26	$114.82	$147.91	$316.23
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $263.03 / $263.03 / $263.03	Professional	52	$263.03	$263.03	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $588.84 / $1,047.13	Professional	TC	$467.74	$588.84	$1,047.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $549.54 / $831.76	Professional		$467.74	$549.54	$831.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $134.90 / $165.96	Professional	26	$109.65	$134.90	$165.96
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $467.74 / $489.78	Professional	TC	$457.09	$467.74	$489.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,071.52	Professional		$1,071.52	$1,071.52	$1,071.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $891.25 / $1,445.44	Professional		$602.56	$891.25	$1,445.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $177.83 / $309.03	Professional	26	$117.49	$177.83	$309.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $691.83 / $1,202.26	Professional	TC	$478.63	$691.83	$1,202.26
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $288.40 / $288.40 / $288.40	Facility	26	$288.40	$288.40	$288.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,000.00 / $6,165.95	Professional		$645.65	$1,000.00	$6,165.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $213.80 / $1,071.52	Professional	26	$128.82	$213.80	$1,071.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $524.81 / $812.83 / $3,890.45	Professional	TC	$524.81	$812.83	$3,890.45
United Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $954.99 / $1,348.96	Professional		$645.65	$954.99	$1,348.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $199.53 / $269.15	Professional	26	$128.82	$199.53	$269.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $524.81 / $741.31 / $1,047.13	Professional	TC	$524.81	$741.31	$1,047.13