Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.39 / $188.67 / $367.34	Facility		$54.39	$188.67	$367.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.20 / $8.85 / $17.37	Facility	26	$7.20	$8.85	$17.37
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.68 / $52.01 / $361.06	Facility	TC	$23.68	$52.01	$361.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.89 / $35.53 / $69.38	Professional		$26.89	$35.53	$69.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $9.27 / $30.42	Professional	26	$7.33	$9.27	$30.42
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $15.80 / $63.26 / $116.92	Professional	50	$15.80	$63.26	$116.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.64 / $26.97 / $52.01	Professional	TC	$21.64	$26.97	$52.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.30 / $29.33 / $72.75	Professional		$25.30	$29.33	$72.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.14 / $8.28 / $19.20	Professional	26	$6.14	$8.28	$19.20
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $44.00 / $109.12 / $109.12	Professional	50	$44.00	$109.12	$109.12
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.54 / $23.95 / $25.96	Professional	TC	$18.54	$23.95	$25.96
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 $25.83 / $67.59 / $103.23	Facility		$25.83	$67.59	$103.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.73 / $43.28 / $60.36	Professional		$26.73	$43.28	$60.36
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 $18.78 / $31.40 / $43.65	Professional	TC	$18.78	$31.40	$43.65
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 Facility Modifier Low / Median / High Price $129.44 / $129.44 / $129.44	Facility		$129.44	$129.44	$129.44
United Facility/Professional Professional Modifier Low / Median / High Price $24.53 / $36.76 / $60.55	Professional		$24.53	$36.76	$60.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $9.92 / $17.87	Professional	26	$7.03	$9.92	$17.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.52 / $26.60 / $43.63	Professional	TC	$17.52	$26.60	$43.63