Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.41 / $166.84 / $261.04	Facility		$75.41	$166.84	$261.04
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.62 / $7.29 / $16.01	Facility	26	$6.62	$7.29	$16.01
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.55 / $36.17 / $357.09	Facility	TC	$18.55	$36.17	$357.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.92 / $28.65 / $50.12	Professional		$24.92	$28.65	$50.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $8.14 / $16.01	Professional	26	$7.08	$8.14	$16.01
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $100.23 / $100.23 / $100.23	Professional	50	$100.23	$100.23	$100.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $21.93 / $43.93	Professional	TC	$17.57	$21.93	$43.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.43 / $26.89 / $61.85	Professional		$19.43	$26.89	$61.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.66 / $7.20 / $17.70	Professional	26	$5.66	$7.20	$17.70
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $92.77 / $92.77 / $92.77	Professional	50	$92.77	$92.77	$92.77
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $15.85 / $20.04	Professional	TC	$15.85	$15.85	$20.04
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 $42.00 / $42.00 / $42.00	Professional		$42.00	$42.00	$42.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.51 / $67.59 / $103.23	Facility		$21.51	$67.59	$103.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.86 / $39.11 / $53.23	Professional		$23.86	$39.11	$53.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.57 / $12.79 / $16.71	Professional	26	$6.57	$12.79	$16.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.23 / $27.81 / $36.19	Professional	TC	$17.23	$27.81	$36.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.44 / $32.34 / $32.34	Professional		$6.44	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $21.39 / $33.08 / $55.46	Professional		$21.39	$33.08	$55.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.89 / $9.38 / $17.60	Professional	26	$6.89	$9.38	$17.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.50 / $23.21 / $38.43	Professional	TC	$14.50	$23.21	$38.43