Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.46 / $166.95 / $301.75	Facility		$49.46	$166.95	$301.75
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.20 / $13.62 / $34.88	Facility	26	$7.20	$13.62	$34.88
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.26 / $49.46 / $332.68	Facility	TC	$27.26	$49.46	$332.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.56 / $40.56 / $77.45	Professional		$30.56	$40.56	$77.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.63 / $8.55 / $17.37	Professional	26	$7.63	$8.55	$17.37
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $75.00 / $75.00 / $75.00	Professional	50	$75.00	$75.00	$75.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.06 / $31.62 / $51.00	Professional	TC	$25.06	$31.62	$51.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.63 / $27.95 / $80.34	Professional		$27.63	$27.95	$80.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.14 / $7.81 / $19.20	Professional	26	$6.14	$7.81	$19.20
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $120.51 / $120.51 / $120.51	Professional	50	$120.51	$120.51	$120.51
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.81 / $27.57 / $30.53	Professional	TC	$21.81	$27.57	$30.53
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 $53.00 / $53.00 / $53.00	Professional		$53.00	$53.00	$53.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.28 / $67.59 / $103.23	Facility		$29.28	$67.59	$103.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $48.04 / $69.45	Professional		$29.51	$48.04	$69.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.13 / $12.97 / $17.23	Professional	26	$7.13	$12.97	$17.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.03 / $34.99 / $52.76	Professional	TC	$22.03	$34.99	$52.76
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 $27.45 / $41.17 / $64.17	Professional		$27.45	$41.17	$64.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.89 / $10.19 / $18.10	Professional	26	$6.89	$10.19	$18.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.86 / $30.98 / $47.33	Professional	TC	$19.86	$30.98	$47.33