Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $147.91 / $288.40	Facility		$75.86	$147.91	$288.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.61 / $7.08 / $42.66	Facility	26	$6.61	$7.08	$42.66
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.62 / $45.71 / $354.81	Facility	TC	$18.62	$45.71	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $34.67 / $69.18	Professional		$14.13	$34.67	$69.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $7.94 / $30.20	Professional	26	$6.61	$7.94	$30.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $54.95 / $77.62 / $134.90	Professional	50	$54.95	$77.62	$134.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $28.84 / $44.67	Professional	TC	$18.20	$28.84	$44.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $24.55 / $40.74	Professional		$19.50	$24.55	$40.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $7.76 / $12.59	Professional	26	$5.89	$7.76	$12.59
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.15 / $56.23 / $95.50	Professional	50	$37.15	$56.23	$95.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $21.88 / $29.51	Professional	TC	$15.14	$21.88	$29.51
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 $41.69 / $41.69 / $41.69	Professional		$41.69	$41.69	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $64.57 / $79.43	Facility		$21.38	$64.57	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $38.02 / $53.70	Professional		$21.88	$38.02	$53.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $11.48 / $16.98	Professional	26	$6.17	$11.48	$16.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $26.92 / $36.31	Professional	TC	$16.22	$26.92	$36.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $32.36 / $33.11	Professional		$17.78	$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 $21.88 / $30.90 / $53.70	Professional		$21.88	$30.90	$53.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $8.91 / $17.78	Professional	26	$6.92	$8.91	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $21.88 / $35.48	Professional	TC	$14.45	$21.88	$35.48