Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.76 / $170.30 / $388.82	Facility		$65.76	$170.30	$388.82
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.78 / $9.53 / $22.00	Facility	26	$7.78	$9.53	$22.00
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.19 / $47.04 / $582.94	Facility	TC	$21.19	$47.04	$582.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.02 / $33.99 / $70.00	Professional		$26.02	$33.99	$70.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $10.11 / $32.86	Professional	26	$8.27	$10.11	$32.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $63.41 / $100.00 / $111.31	Professional	50	$63.41	$100.00	$111.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $23.87 / $47.04	Professional	TC	$19.14	$23.87	$47.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.58 / $29.47 / $51.08	Professional		$23.58	$29.47	$51.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.62 / $8.42 / $20.70	Professional	26	$6.62	$8.42	$20.70
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $40.90 / $49.51 / $101.67	Professional	50	$40.90	$49.51	$101.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.95 / $20.67 / $22.97	Professional	TC	$16.95	$20.67	$22.97
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 $46.00 / $46.00 / $46.00	Professional		$46.00	$46.00	$46.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.05 / $67.59 / $165.23	Facility		$24.05	$67.59	$165.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.54 / $41.44 / $57.87	Professional		$25.54	$41.44	$57.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.70 / $14.01 / $19.07	Professional	26	$7.70	$14.01	$19.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.61 / $28.38 / $38.79	Professional	TC	$16.61	$28.38	$38.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.54 / $32.34 / $32.34	Professional		$7.54	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $23.88 / $35.47 / $60.53	Professional		$23.88	$35.47	$60.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.74 / $10.57 / $18.89	Professional	26	$7.74	$10.57	$18.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.01 / $23.82 / $40.49	Professional	TC	$16.01	$23.82	$40.49