Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $162.18 / $389.05	Facility		$77.62	$162.18	$389.05
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $10.00 / $64.57	Facility	26	$9.33	$10.00	$64.57
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $70.79 / $309.03	Facility	TC	$30.20	$70.79	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $52.48 / $93.33	Professional		$10.23	$52.48	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.48 / $37.15	Professional	26	$8.91	$11.48	$37.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $26.30 / $26.30 / $158.49	Professional	50	$26.30	$26.30	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $40.74 / $57.54	Professional	TC	$28.84	$40.74	$57.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $38.02 / $63.10	Professional		$29.51	$38.02	$63.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.23 / $17.38	Professional	26	$8.13	$10.23	$17.38
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $51.29 / $51.29 / $102.33	Professional	50	$51.29	$51.29	$102.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $30.90 / $48.98	Professional	TC	$23.44	$30.90	$48.98
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 $63.10 / $63.10 / $63.10	Professional		$63.10	$63.10	$63.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $69.18 / $79.43	Facility		$67.61	$69.18	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $54.95 / $77.62	Professional		$32.36	$54.95	$77.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $15.14 / $22.39	Professional	26	$7.76	$15.14	$22.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $39.81 / $54.95	Professional	TC	$24.55	$39.81	$54.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $32.36 / $33.11	Professional		$27.54	$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 $31.62 / $45.71 / $79.43	Professional		$31.62	$45.71	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $12.30 / $22.91	Professional	26	$9.33	$12.30	$22.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $33.88 / $56.23	Professional	TC	$22.39	$33.88	$56.23