Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.44 / $122.38 / $301.75	Facility		$48.44	$122.38	$301.75
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.78 / $8.52 / $18.73	Facility	26	$7.78	$8.52	$18.73
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.15 / $48.44 / $331.39	Facility	TC	$26.15	$48.44	$331.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.00 / $40.57 / $77.56	Professional		$23.00	$40.57	$77.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.98 / $9.52 / $32.86	Professional	26	$7.98	$9.52	$32.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $37.00 / $70.27 / $128.00	Professional	50	$37.00	$70.27	$128.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.14 / $28.22 / $38.78	Professional	52	$16.14	$28.22	$38.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.44 / $31.79 / $58.84	Professional	TC	$24.44	$31.79	$58.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.21 / $34.43 / $79.19	Professional		$27.21	$34.43	$79.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.62 / $8.42 / $20.70	Professional	26	$6.62	$8.42	$20.70
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $47.87 / $118.78 / $118.78	Professional	50	$47.87	$118.78	$118.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.92 / $26.45 / $29.29	Professional	TC	$20.92	$26.45	$29.29
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 $53.00 / $53.00 / $53.00	Professional		$53.00	$53.00	$53.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.80 / $67.59 / $165.23	Facility		$28.80	$67.59	$165.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.74 / $48.55 / $69.40	Professional		$29.74	$48.55	$69.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.70 / $14.14 / $19.07	Professional	26	$7.70	$14.14	$19.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.73 / $35.97 / $50.33	Professional	TC	$21.73	$35.97	$50.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.54 / $32.34 / $32.34	Professional		$7.54	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $28.47 / $40.79 / $66.33	Professional		$28.47	$40.79	$66.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.65 / $11.00 / $18.89	Professional	26	$7.65	$11.00	$18.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.41 / $30.62 / $48.66	Professional	TC	$20.41	$30.62	$48.66