Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $258.99 / $295.37 / $863.00	Professional		$258.99	$295.37	$863.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $156.71 / $175.59 / $287.54	Professional	26	$156.71	$175.59	$287.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.35 / $115.98 / $174.46	Professional	TC	$91.35	$115.98	$174.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $270.29 / $270.29 / $457.97	Professional		$270.29	$270.29	$457.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.72 / $198.31 / $300.39	Professional		$148.72	$198.31	$300.39
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.62 / $111.50 / $139.37	Professional	26	$83.62	$111.50	$139.37
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $65.11 / $86.82 / $108.52	Professional	TC	$65.11	$86.82	$108.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $208.62 / $208.62 / $208.62	Facility	26	$208.62	$208.62	$208.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.90 / $351.44 / $622.69	Professional		$102.90	$351.44	$622.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $179.24 / $255.64 / $414.39	Professional	26	$179.24	$255.64	$414.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.11 / $151.30 / $248.83	Professional	TC	$100.11	$151.30	$248.83
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $425.11 / $829.58 / $829.58	Facility	26	$425.11	$829.58	$829.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $266.60 / $346.71 / $1,850.58	Professional		$266.60	$346.71	$1,850.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $167.09 / $216.80 / $1,166.03	Professional	26	$167.09	$216.80	$1,166.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $100.63 / $133.54 / $684.55	Professional	TC	$100.63	$133.54	$684.55
United Facility/Professional Professional Modifier Low / Median / High Price $266.60 / $325.89 / $617.63	Professional		$266.60	$325.89	$617.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $167.09 / $195.12 / $387.09	Professional	26	$167.09	$195.12	$387.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $99.51 / $121.45 / $230.54	Professional	TC	$99.51	$121.45	$230.54