Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $162.18 / $309.03	Facility		$75.86	$162.18	$309.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $7.76 / $43.65	Facility	26	$7.08	$7.76	$43.65
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.91 / $56.23 / $616.60	Facility	TC	$22.91	$56.23	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $43.65 / $89.13	Professional		$10.47	$43.65	$89.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.33 / $35.48	Professional	26	$7.08	$9.33	$35.48
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $66.07 / $107.15 / $138.04	Professional	50	$66.07	$107.15	$138.04
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $81.28 / $81.28 / $81.28	Professional	52	$81.28	$81.28	$81.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $34.67 / $56.23	Professional	TC	$22.91	$34.67	$56.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $27.54 / $47.86	Professional		$22.39	$27.54	$47.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $8.13 / $15.49	Professional	26	$6.17	$8.13	$15.49
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $32.36 / $41.69 / $83.18	Professional	50	$32.36	$41.69	$83.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $23.44 / $39.81	Professional	TC	$17.78	$23.44	$39.81
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 $46.77 / $46.77 / $46.77	Professional		$46.77	$46.77	$46.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $64.57 / $79.43	Facility		$25.70	$64.57	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $41.69 / $61.66	Professional		$25.12	$41.69	$61.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $12.30 / $17.38	Professional	26	$6.76	$12.30	$17.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $30.90 / $45.71	Professional	TC	$18.62	$30.90	$45.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $32.36 / $33.11	Professional		$20.89	$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 $23.99 / $35.48 / $54.95	Professional		$23.99	$35.48	$54.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.12 / $18.20	Professional	26	$7.08	$9.12	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $25.70 / $38.02	Professional	TC	$17.38	$25.70	$38.02