Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $154.88 / $338.84	Facility		$60.26	$154.88	$338.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $7.76 / $14.13	Facility	26	$7.76	$7.76	$14.13
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.55 / $61.66 / $616.60	Facility	TC	$24.55	$61.66	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $47.86 / $114.82	Professional		$16.60	$47.86	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.72 / $40.74	Professional	26	$7.94	$10.72	$40.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.38 / $67.61 / $128.82	Professional	50	$17.38	$67.61	$128.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $40.74 / $74.13	Professional	TC	$25.12	$40.74	$74.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $31.62 / $52.48	Professional		$25.70	$31.62	$52.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $8.91 / $15.14	Professional	26	$6.76	$8.91	$15.14
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.15 / $47.86 / $87.10	Professional	50	$37.15	$47.86	$87.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $28.84 / $45.71	Professional	TC	$20.42	$28.84	$45.71
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 $52.48 / $52.48 / $52.48	Professional		$52.48	$52.48	$52.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $64.57 / $79.43	Facility		$28.84	$64.57	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $45.71 / $69.18	Professional		$27.54	$45.71	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $13.18 / $19.05	Professional	26	$7.24	$13.18	$19.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $35.48 / $50.12	Professional	TC	$20.42	$35.48	$50.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $32.36 / $33.11	Professional		$23.44	$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 $26.92 / $39.81 / $58.88	Professional		$26.92	$39.81	$58.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.00 / $19.05	Professional	26	$7.59	$10.00	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $28.84 / $41.69	Professional	TC	$19.50	$28.84	$41.69