Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.43 / $152.88 / $230.35	Facility	26	$114.43	$152.88	$230.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $552.85 / $615.14 / $855.66	Professional		$552.85	$615.14	$855.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.29 / $125.28 / $158.54	Professional	26	$114.29	$125.28	$158.54
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $248.38 / $302.61 / $399.19	Professional	52	$248.38	$302.61	$399.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $438.41 / $494.16 / $683.99	Professional	TC	$438.41	$494.16	$683.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $105.19 / $141.56 / $152.88	Professional	26	$105.19	$141.56	$152.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $121.80 / $590.10 / $810.29	Professional		$121.80	$590.10	$810.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $632.86 / $819.68 / $1,168.26	Professional		$632.86	$819.68	$1,168.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $121.11 / $168.94 / $268.64	Professional	26	$121.11	$168.94	$268.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $500.00 / $660.48 / $922.23	Professional	TC	$500.00	$660.48	$922.23
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $286.83 / $753.90 / $753.90	Facility	26	$286.83	$753.90	$753.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $556.79 / $854.33 / $6,200.00	Professional		$556.79	$854.33	$6,200.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $109.82 / $190.17 / $1,081.48	Professional	26	$109.82	$190.17	$1,081.48
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $441.74 / $727.57 / $3,875.48	Professional	TC	$441.74	$727.57	$3,875.48
United Facility/Professional Professional Modifier Low / Median / High Price $551.55 / $713.78 / $1,240.21	Professional		$551.55	$713.78	$1,240.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.82 / $167.96 / $245.40	Professional	26	$109.82	$167.96	$245.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $441.74 / $604.79 / $994.17	Professional	TC	$441.74	$604.79	$994.17