Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.12 / $183.96 / $297.35	Facility		$74.12	$183.96	$297.35
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.20 / $7.79 / $17.37	Facility	26	$7.20	$7.79	$17.37
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.12 / $52.63 / $361.06	Facility	TC	$23.12	$52.63	$361.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.90 / $35.90 / $70.00	Professional		$7.90	$35.90	$70.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.01 / $17.37	Professional	26	$7.33	$8.01	$17.37
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $66.31 / $66.31 / $108.00	Professional	50	$66.31	$66.31	$108.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.65 / $25.47 / $35.00	Professional	52	$14.65	$25.47	$35.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.94 / $27.35 / $48.98	Professional	TC	$21.94	$27.35	$48.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.64 / $28.20 / $70.84	Professional		$24.64	$28.20	$70.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.14 / $7.68 / $19.20	Professional	26	$6.14	$7.68	$19.20
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $42.84 / $106.26 / $106.26	Professional	50	$42.84	$106.26	$106.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.55 / $23.39 / $25.90	Professional	TC	$22.55	$23.39	$25.90
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 $47.00 / $47.00 / $47.00	Professional		$47.00	$47.00	$47.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.83 / $67.59 / $165.23	Facility		$25.83	$67.59	$165.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.73 / $43.28 / $62.17	Professional		$26.73	$43.28	$62.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.13 / $12.97 / $17.23	Professional	26	$7.13	$12.97	$17.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.09 / $31.39 / $45.46	Professional	TC	$19.09	$31.39	$45.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.99 / $32.34 / $32.34	Professional		$6.99	$32.34	$32.34
United Facility/Professional Facility Modifier Low / Median / High Price $129.44 / $129.44 / $129.44	Facility		$129.44	$129.44	$129.44
United Facility/Professional Professional Modifier Low / Median / High Price $25.38 / $37.10 / $60.55	Professional		$25.38	$37.10	$60.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $9.92 / $18.10	Professional	26	$7.03	$9.92	$18.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.18 / $26.91 / $42.90	Professional	TC	$17.18	$26.91	$42.90