Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.17 / $165.75 / $396.91	Facility		$43.17	$165.75	$396.91
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.97 / $10.81 / $14.59	Facility	26	$8.97	$10.81	$14.59
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.38 / $43.69 / $360.89	Facility	TC	$28.38	$43.69	$360.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.10 / $32.08 / $45.33	Professional		$26.10	$32.08	$45.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.58 / $8.09 / $11.35	Professional	26	$6.58	$8.09	$11.35
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.55 / $16.04 / $21.59	Professional	52	$12.55	$16.04	$21.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.46 / $23.06 / $33.97	Professional	TC	$19.46	$23.06	$33.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.33 / $32.28 / $38.64	Professional		$23.33	$32.28	$38.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.86 / $8.24 / $13.23	Professional	26	$5.86	$8.24	$13.23
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.18 / $48.42 / $57.96	Professional	50	$37.18	$48.42	$57.96
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.84 / $18.55 / $128.00	Professional	TC	$14.84	$18.55	$128.00
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 $31.25 / $42.81 / $50.52	Professional		$31.25	$42.81	$50.52
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.96 / $12.27 / $14.48	Professional	26	$8.96	$12.27	$14.48
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.29 / $30.54 / $36.04	Professional	TC	$22.29	$30.54	$36.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.94 / $108.05 / $202.38	Facility		$38.94	$108.05	$202.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.38 / $9.38 / $9.46	Facility	26	$9.38	$9.38	$9.46
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $18.46 / $18.46 / $18.62	Facility	TC	$18.46	$18.46	$18.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $34.29 / $81.56	Professional		$23.44	$34.29	$81.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.47 / $11.41 / $23.00	Professional	26	$6.47	$11.41	$23.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.09 / $24.61 / $61.88	Professional	TC	$17.09	$24.61	$61.88
United Facility/Professional Facility Modifier Low / Median / High Price $72.81 / $159.62 / $161.80	Facility		$72.81	$159.62	$161.80
United Facility/Professional Professional Modifier Low / Median / High Price $23.74 / $31.28 / $40.70	Professional		$23.74	$31.28	$40.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.54 / $8.27 / $11.60	Professional	26	$6.54	$8.27	$11.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.67 / $22.72 / $30.31	Professional	TC	$16.67	$22.72	$30.31