Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.15 / $181.90 / $323.64	Facility		$35.15	$181.90	$323.64
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.90 / $8.47 / $16.63	Facility	26	$6.90	$8.47	$16.63
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.01 / $33.47 / $44.41	Facility	TC	$18.01	$33.47	$44.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.92 / $32.42 / $59.33	Professional		$24.92	$32.42	$59.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $8.22 / $29.12	Professional	26	$7.03	$8.22	$29.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.00 / $33.00 / $33.00	Professional	50	$33.00	$33.00	$33.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.46 / $21.59 / $29.67	Professional	52	$12.46	$21.59	$29.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $22.31 / $42.70	Professional	TC	$17.89	$22.31	$42.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.71 / $24.33 / $61.23	Professional		$18.71	$24.33	$61.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.88 / $7.35 / $18.38	Professional	26	$5.88	$7.35	$18.38
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $28.39 / $39.93 / $91.84	Professional	50	$28.39	$39.93	$91.84
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.48 / $19.48 / $20.78	Professional	TC	$19.48	$19.48	$20.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.59 / $158.59 / $174.45	Facility		$158.59	$158.59	$174.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.00 / $41.00 / $41.00	Professional		$41.00	$41.00	$41.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.95 / $92.57 / $165.23	Facility		$21.95	$92.57	$165.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.99 / $37.59 / $52.37	Professional		$22.99	$37.59	$52.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.84 / $12.30 / $16.30	Professional	26	$6.84	$12.30	$16.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.38 / $26.21 / $36.36	Professional	TC	$15.38	$26.21	$36.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.70 / $32.34 / $32.34	Professional		$6.70	$32.34	$32.34
United Facility/Professional Facility Modifier Low / Median / High Price $174.35 / $174.35 / $174.35	Facility		$174.35	$174.35	$174.35
United Facility/Professional Professional Modifier Low / Median / High Price $21.48 / $32.22 / $53.87	Professional		$21.48	$32.22	$53.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.27 / $16.45	Professional	26	$6.61	$9.27	$16.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.90 / $21.35 / $37.60	Professional	TC	$14.90	$21.35	$37.60