Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.54 / $209.00 / $576.50	Facility		$46.54	$209.00	$576.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.97 / $11.27 / $15.22	Facility	26	$8.97	$11.27	$15.22
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $35.28 / $210.74 / $403.74	Facility	TC	$35.28	$210.74	$403.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.94 / $33.32 / $48.87	Professional		$27.94	$33.32	$48.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.87 / $8.44 / $11.84	Professional	26	$6.87	$8.44	$11.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.41 / $17.17 / $23.28	Professional	52	$13.41	$17.17	$23.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.28 / $24.88 / $37.04	Professional	TC	$20.28	$24.88	$37.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.35 / $36.96 / $41.30	Professional		$24.35	$36.96	$41.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.12 / $8.60 / $10.14	Professional	26	$6.12	$8.60	$10.14
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $55.44 / $55.44 / $55.44	Professional	50	$55.44	$55.44	$55.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.99 / $18.80 / $20.60	Professional	TC	$15.99	$18.80	$20.60
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 $32.85 / $45.00 / $53.10	Professional		$32.85	$45.00	$53.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.99 / $13.69 / $16.14	Professional	26	$9.99	$13.69	$16.14
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.86 / $31.31 / $36.95	Professional	TC	$22.86	$31.31	$36.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.74 / $108.05 / $202.38	Facility		$41.74	$108.05	$202.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.38 / $9.38 / $9.46	Facility	26	$9.38	$9.38	$9.46
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $20.93 / $20.93 / $21.11	Facility	TC	$20.93	$20.93	$21.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.02 / $35.60 / $86.73	Professional		$25.02	$35.60	$86.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $10.95 / $23.00	Professional	26	$6.74	$10.95	$23.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.11 / $27.50 / $66.79	Professional	TC	$19.11	$27.50	$66.79
United Facility/Professional Facility Modifier Low / Median / High Price $6.27 / $21.17 / $159.62	Facility		$6.27	$21.17	$159.62
United Facility/Professional Professional Modifier Low / Median / High Price $24.76 / $32.63 / $42.44	Professional		$24.76	$32.63	$42.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.77 / $8.64 / $12.10	Professional	26	$6.77	$8.64	$12.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.61 / $23.65 / $31.62	Professional	TC	$17.61	$23.65	$31.62