Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.86 / $113.42 / $263.52	Facility		$37.86	$113.42	$263.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.25 / $10.15 / $22.30	Facility	26	$9.25	$10.15	$22.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.19 / $36.40 / $70.58	Professional		$29.19	$36.40	$70.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.26 / $10.47 / $22.30	Professional	26	$9.26	$10.47	$22.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $24.65 / $48.00	Professional	TC	$19.76	$24.65	$48.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.05 / $26.62 / $72.01	Professional		$25.05	$26.62	$72.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.88 / $11.03 / $24.60	Professional	26	$7.88	$11.03	$24.60
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.72 / $21.72 / $23.27	Professional	TC	$21.72	$21.72	$23.27
BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.76 / $95.76 / $105.34	Facility		$95.76	$95.76	$105.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.00 / $49.00 / $49.00	Professional		$49.00	$49.00	$49.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.35 / $67.59 / $103.23	Facility		$25.35	$67.59	$103.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.92 / $45.43 / $61.64	Professional		$27.92	$45.43	$61.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.90 / $16.63 / $22.18	Professional	26	$8.90	$16.63	$22.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.47 / $29.78 / $40.01	Professional	TC	$18.47	$29.78	$40.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.86 / $32.34 / $32.34	Professional		$8.86	$32.34	$32.34
United Facility/Professional Facility Modifier Low / Median / High Price $129.44 / $129.44 / $129.44	Facility		$129.44	$129.44	$129.44
United Facility/Professional Professional Modifier Low / Median / High Price $25.35 / $38.15 / $65.27	Professional		$25.35	$38.15	$65.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.09 / $12.71 / $22.75	Professional	26	$9.09	$12.71	$22.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.32 / $25.06 / $43.24	Professional	TC	$16.32	$25.06	$43.24