Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $208.93 / $426.58	Facility		$46.77	$208.93	$426.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $10.00 / $22.91	Facility	26	$9.33	$10.00	$22.91
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.44 / $58.88 / $416.87	Facility	TC	$23.44	$58.88	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $41.69 / $77.62	Professional		$30.90	$41.69	$77.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.02 / $26.92	Professional	26	$8.91	$12.02	$26.92
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $26.92 / $38.02 / $147.91	Professional	50	$26.92	$38.02	$147.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $30.90 / $52.48	Professional	TC	$23.99	$30.90	$52.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $31.62 / $58.88	Professional		$25.70	$31.62	$58.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.23 / $17.38	Professional	26	$7.94	$10.23	$17.38
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $52.48 / $52.48 / $52.48	Professional	50	$52.48	$52.48	$52.48
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $14.13 / $14.13 / $15.14	Professional	52	$14.13	$14.13	$15.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $30.20 / $45.71	Professional	TC	$23.99	$30.20	$45.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $173.78	Facility		$158.49	$158.49	$173.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $97.72 / $125.89	Facility		$93.33	$97.72	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $50.12 / $74.13	Professional		$28.84	$50.12	$74.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $15.49 / $22.39	Professional	26	$7.76	$15.49	$22.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $34.67 / $50.12	Professional	TC	$20.42	$34.67	$50.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $32.36 / $33.11	Professional		$22.91	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $208.93 / $223.87	Facility		$77.62	$208.93	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $41.69 / $75.86	Professional		$30.20	$41.69	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $12.30 / $23.44	Professional	26	$9.33	$12.30	$23.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $28.84 / $52.48	Professional	TC	$20.42	$28.84	$52.48