Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $154.88 / $436.52	Facility		$75.86	$154.88	$436.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $7.94 / $38.02	Facility	26	$7.76	$7.94	$38.02
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.89 / $81.28 / $602.56	Facility	TC	$20.89	$81.28	$602.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $41.69 / $95.50	Professional		$17.38	$41.69	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.00 / $37.15	Professional	26	$7.59	$10.00	$37.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $25.70 / $77.62 / $112.20	Professional	50	$25.70	$77.62	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $31.62 / $79.43	Professional	TC	$19.95	$31.62	$79.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $27.54 / $42.66	Professional		$21.38	$27.54	$42.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $8.91 / $14.13	Professional	26	$6.92	$8.91	$14.13
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.15 / $46.77 / $81.28	Professional	50	$37.15	$46.77	$81.28
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $22.39 / $37.15	Professional	TC	$16.98	$22.39	$37.15
BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $104.71	Facility		$95.50	$95.50	$104.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $45.71	Professional		$45.71	$45.71	$45.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $64.57 / $79.43	Facility		$23.99	$64.57	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $40.74 / $57.54	Professional		$23.44	$40.74	$57.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $13.18 / $19.05	Professional	26	$7.24	$13.18	$19.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $27.54 / $38.90	Professional	TC	$16.22	$27.54	$38.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $32.36 / $33.11	Professional		$19.05	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $158.49 / $173.78	Facility		$63.10	$158.49	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $33.88 / $58.88	Professional		$23.99	$33.88	$58.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.00 / $19.05	Professional	26	$7.59	$10.00	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $23.44 / $40.74	Professional	TC	$15.85	$23.44	$40.74