Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.46 / $90.10 / $468.66	Facility		$27.46	$90.10	$468.66
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.23 / $10.39 / $14.02	Facility	26	$8.23	$10.39	$14.02
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.42 / $30.30 / $30.63	Facility	TC	$20.42	$30.30	$30.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.86 / $29.51 / $40.69	Professional		$23.86	$29.51	$40.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.28 / $7.96 / $10.58	Professional	26	$6.28	$7.96	$10.58
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.93 / $15.25 / $20.35	Professional	52	$11.93	$15.25	$20.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $20.94 / $30.30	Professional	TC	$17.57	$20.94	$30.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.48 / $32.60 / $36.40	Professional		$21.48	$32.60	$36.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.64 / $6.02 / $8.50	Professional	26	$5.64	$6.02	$8.50
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $35.03 / $48.91 / $48.91	Professional	50	$35.03	$48.91	$48.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.34 / $16.34 / $16.34	Professional	TC	$16.34	$16.34	$16.34
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 $28.47 / $39.00 / $46.02	Professional		$28.47	$39.00	$46.02
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.53 / $11.70 / $13.81	Professional	26	$8.53	$11.70	$13.81
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.93 / $27.30 / $32.21	Professional	TC	$19.93	$27.30	$32.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.44 / $108.05 / $202.38	Facility		$37.44	$108.05	$202.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.61 / $8.61 / $8.69	Facility	26	$8.61	$8.61	$8.69
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $17.75 / $17.75 / $17.89	Facility	TC	$17.75	$17.75	$17.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.22 / $31.42 / $76.15	Professional		$22.22	$31.42	$76.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.20 / $10.51 / $20.00	Professional	26	$6.20	$10.51	$20.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.30 / $23.34 / $57.96	Professional	TC	$16.30	$23.34	$57.96
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 $22.48 / $29.06 / $38.54	Professional		$22.48	$29.06	$38.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.50 / $8.23 / $10.64	Professional	26	$6.50	$8.23	$10.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.78 / $20.78 / $27.45	Professional	TC	$14.78	$20.78	$27.45