Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.29 / $114.90 / $367.92	Facility		$37.29	$114.90	$367.92
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.20 / $8.85 / $17.37	Facility	26	$7.20	$8.85	$17.37
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $15.03 / $29.53 / $442.23	Facility	TC	$15.03	$29.53	$442.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.25 / $29.78 / $53.28	Professional		$22.25	$29.78	$53.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.21 / $8.36 / $17.37	Professional	26	$7.21	$8.36	$17.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.04 / $20.38 / $35.86	Professional	TC	$15.04	$20.38	$35.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.13 / $19.30 / $54.99	Professional		$19.13	$19.30	$54.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.14 / $8.28 / $19.20	Professional	26	$6.14	$8.28	$19.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.42 / $16.42 / $16.42	Professional	TC	$16.42	$16.42	$16.42
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 $42.00 / $42.00 / $42.00	Professional		$42.00	$42.00	$42.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.22 / $92.57 / $165.23	Facility		$20.22	$92.57	$165.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.87 / $38.86 / $55.78	Professional		$22.87	$38.86	$55.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.13 / $13.18 / $17.78	Professional	26	$7.13	$13.18	$17.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.73 / $26.55 / $38.25	Professional	TC	$15.73	$26.55	$38.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.99 / $32.34 / $32.34	Professional		$6.99	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $21.57 / $30.43 / $54.00	Professional		$21.57	$30.43	$54.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.34 / $10.34 / $18.04	Professional	26	$7.34	$10.34	$18.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.71 / $20.55 / $36.13	Professional	TC	$13.71	$20.55	$36.13