Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.64 / $120.25 / $443.70	Facility		$28.64	$120.25	$443.70
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.33 / $10.81 / $10.81	Facility	26	$7.33	$10.81	$10.81
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.57 / $28.64 / $29.37	Facility	TC	$19.57	$28.64	$29.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.78 / $28.29 / $39.45	Professional		$23.78	$28.29	$39.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.58 / $7.96 / $10.81	Professional	26	$6.58	$7.96	$10.81
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.44 / $14.61 / $19.73	Professional	52	$11.44	$14.61	$19.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.19 / $20.32 / $28.64	Professional	TC	$17.19	$20.32	$28.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.71 / $22.87 / $22.87	Professional		$18.71	$22.87	$22.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.86 / $6.47 / $13.23	Professional	26	$5.86	$6.47	$13.23
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $34.31 / $34.31 / $34.31	Professional	50	$34.31	$34.31	$34.31
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.32 / $13.32 / $13.32	Professional	TC	$13.32	$13.32	$13.32
BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.40 / $92.49 / $124.43	Facility		$76.40	$92.49	$124.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.11 / $38.50 / $45.43	Professional		$28.11	$38.50	$45.43
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.85 / $12.12 / $14.30	Professional	26	$8.85	$12.12	$14.30
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.26 / $26.38 / $31.13	Professional	TC	$19.26	$26.38	$31.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.49 / $130.72 / $272.39	Facility		$36.49	$130.72	$272.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.61 / $8.61 / $8.69	Facility	26	$8.61	$8.61	$8.69
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $17.75 / $17.75 / $17.89	Facility	TC	$17.75	$17.75	$17.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.43 / $30.66 / $74.50	Professional		$21.43	$30.66	$74.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $10.51 / $20.00	Professional	26	$6.46	$10.51	$20.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.05 / $22.43 / $52.72	Professional	TC	$16.05	$22.43	$52.72
United Facility/Professional Facility Modifier Low / Median / High Price $98.07 / $217.94 / $224.16	Facility		$98.07	$217.94	$224.16
United Facility/Professional Professional Modifier Low / Median / High Price $21.25 / $28.34 / $36.82	Professional		$21.25	$28.34	$36.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.50 / $8.27 / $11.38	Professional	26	$6.50	$8.27	$11.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.31 / $19.82 / $26.42	Professional	TC	$14.31	$19.82	$26.42