Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $1,047.13 / $1,995.26	Facility		$416.87	$1,047.13	$1,995.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $36.31 / $107.15	Facility	26	$36.31	$36.31	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $213.80 / $501.19	Professional		$173.78	$213.80	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $42.66 / $107.15	Professional	26	$37.15	$42.66	$107.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $158.49 / $389.05	Professional	TC	$134.90	$158.49	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $154.88 / $338.84	Professional		$107.15	$154.88	$338.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $44.67 / $79.43	Professional	26	$42.66	$44.67	$79.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $125.89 / $144.54	Professional	TC	$109.65	$125.89	$144.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Professional		$302.00	$302.00	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $229.09 / $331.13	Professional		$112.20	$229.09	$331.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $70.79 / $107.15	Professional	26	$38.90	$70.79	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $165.96 / $229.09	Professional	TC	$70.79	$165.96	$229.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $588.84 / $1,659.59	Facility		$338.84	$588.84	$1,659.59
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $199.53 / $407.38	Professional		$131.83	$199.53	$407.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $57.54 / $109.65	Professional	26	$38.02	$57.54	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $131.83 / $302.00	Professional	TC	$85.11	$131.83	$302.00