Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $281.84 / $933.25	Professional		$199.53	$281.84	$933.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $151.36 / $501.19	Professional	26	$117.49	$151.36	$501.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $91.20 / $169.82	Professional	TC	$75.86	$91.20	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $213.80 / $363.08	Professional		$181.97	$213.80	$363.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $123.03 / $218.78	Professional	26	$120.23	$123.03	$218.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $186.21 / $316.23	Professional		$141.25	$186.21	$316.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $93.33 / $177.83	Professional	26	$77.62	$93.33	$177.83
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $72.44 / $138.04	Professional	TC	$60.26	$72.44	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $295.12 / $501.19	Professional		$208.93	$295.12	$501.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $173.78 / $295.12	Professional	26	$128.82	$173.78	$295.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $120.23 / $208.93	Professional	TC	$87.10	$120.23	$208.93
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $302.00 / $588.84 / $588.84	Facility	26	$302.00	$588.84	$588.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $281.84 / $1,380.38	Professional		$199.53	$281.84	$1,380.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $165.96 / $831.76	Professional	26	$117.49	$165.96	$831.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $117.49 / $549.54	Professional	TC	$83.18	$117.49	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $245.47 / $436.52	Professional		$194.98	$245.47	$436.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $144.54 / $257.04	Professional	26	$114.82	$144.54	$257.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $104.71 / $181.97	Professional	TC	$81.28	$104.71	$181.97