Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.51 / $157.50 / $390.63	Facility		$28.51	$157.50	$390.63
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.50 / $8.25 / $18.11	Facility	26	$7.50	$8.25	$18.11
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.00 / $39.32 / $52.16	Facility	TC	$21.00	$39.32	$52.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.51 / $40.93 / $68.25	Professional		$28.51	$40.93	$68.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $12.21 / $22.01	Professional	26	$7.59	$12.21	$22.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.00 / $28.52 / $50.15	Professional	TC	$21.00	$28.52	$50.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.30 / $70.31 / $70.31	Professional		$28.30	$70.31	$70.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.40 / $12.05 / $20.00	Professional	26	$6.40	$12.05	$20.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.59 / $158.59 / $174.45	Facility		$158.59	$158.59	$174.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $55.00 / $55.00	Professional		$55.00	$55.00	$55.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.37 / $92.57 / $165.23	Facility		$28.37	$92.57	$165.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.34 / $49.18 / $69.50	Professional		$29.34	$49.18	$69.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.43 / $17.93 / $23.46	Professional	26	$7.43	$17.93	$23.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.63 / $32.22 / $46.08	Professional	TC	$19.63	$32.22	$46.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.29 / $32.34 / $32.34	Professional		$7.29	$32.34	$32.34
United Facility/Professional Facility Modifier Low / Median / High Price $133.57 / $194.39 / $314.85	Facility		$133.57	$194.39	$314.85
United Facility/Professional Professional Modifier Low / Median / High Price $28.68 / $38.47 / $71.08	Professional		$28.68	$38.47	$71.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.67 / $11.73 / $21.98	Professional	26	$9.67	$11.73	$21.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.69 / $26.25 / $47.59	Professional	TC	$17.69	$26.25	$47.59