Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.35 / $164.00 / $361.62	Facility		$44.35	$164.00	$361.62
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.44 / $10.15 / $22.30	Facility	26	$6.44	$10.15	$22.30
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.95 / $53.87 / $507.92	Facility	TC	$23.95	$53.87	$507.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.18 / $45.00 / $76.22	Professional		$30.18	$45.00	$76.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.60 / $10.75 / $23.40	Professional	26	$9.60	$10.75	$23.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.95 / $33.17 / $53.87	Professional	TC	$23.95	$33.17	$53.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.04 / $33.79 / $77.72	Professional		$27.04	$33.79	$77.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.88 / $9.84 / $18.66	Professional	26	$7.88	$9.84	$18.66
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.16 / $24.22 / $26.82	Professional	TC	$19.16	$24.22	$26.82
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 $57.00 / $57.00 / $57.00	Professional		$57.00	$57.00	$57.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.25 / $92.57 / $165.23	Facility		$32.25	$92.57	$165.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.87 / $49.90 / $69.17	Professional		$30.87	$49.90	$69.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.17 / $16.63 / $22.50	Professional	26	$9.17	$16.63	$22.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.05 / $33.24 / $46.68	Professional	TC	$21.05	$33.24	$46.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.97 / $32.34 / $32.34	Professional		$8.97	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $28.54 / $40.75 / $75.42	Professional		$28.54	$40.75	$75.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.24 / $12.47 / $22.01	Professional	26	$9.24	$12.47	$22.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.26 / $28.07 / $51.86	Professional	TC	$19.26	$28.07	$51.86