Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $229.09 / $616.60	Facility		$43.65	$229.09	$616.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $12.02 / $12.02	Facility	26	$8.51	$12.02	$12.02
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.62 / $31.62 / $467.74	Facility	TC	$31.62	$31.62	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $35.48 / $83.18	Professional		$8.91	$35.48	$83.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $16.60 / $40.74	Professional	26	$7.94	$16.60	$40.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.88 / $79.43 / $158.49	Professional	50	$33.88	$79.43	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $32.36 / $79.43	Professional	TC	$18.20	$32.36	$79.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $27.54 / $43.65	Professional		$21.88	$27.54	$43.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $8.71 / $12.88	Professional	26	$6.76	$8.71	$12.88
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $33.88 / $38.90 / $67.61	Professional	50	$33.88	$38.90	$67.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $20.42 / $32.36	Professional	TC	$16.22	$20.42	$32.36
BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $93.33 / $125.89	Facility		$79.43	$93.33	$125.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $42.66 / $54.95	Professional		$29.51	$42.66	$54.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $15.14 / $19.50	Professional	26	$10.47	$15.14	$19.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $27.54 / $35.48	Professional	TC	$19.05	$27.54	$35.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $109.65 / $204.17	Facility		$36.31	$109.65	$204.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $10.23 / $10.23	Facility	26	$10.23	$10.23	$10.23
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $19.05 / $19.05 / $19.50	Facility	TC	$19.05	$19.05	$19.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $35.48 / $72.44	Professional		$22.39	$35.48	$72.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.30 / $23.99	Professional	26	$8.32	$12.30	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $26.92 / $56.23	Professional	TC	$18.20	$26.92	$56.23
United Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $128.82 / $158.49	Facility		$19.50	$128.82	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $30.90 / $43.65	Professional		$23.44	$30.90	$43.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.33 / $13.80	Professional	26	$7.08	$9.33	$13.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $21.88 / $29.51	Professional	TC	$15.85	$21.88	$29.51