Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.58 / $83.70 / $259.56	Facility		$29.58	$83.70	$259.56
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.36 / $7.01 / $15.39	Facility	26	$6.36	$7.01	$15.39
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.39 / $30.07 / $39.88	Facility	TC	$16.39	$30.07	$39.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.76 / $30.70 / $61.00	Professional		$22.76	$30.70	$61.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $7.83 / $15.39	Professional	26	$6.71	$7.83	$15.39
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.38 / $19.55 / $26.88	Professional	52	$11.38	$19.55	$26.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.39 / $23.27 / $39.60	Professional	TC	$16.39	$23.27	$39.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.13 / $19.30 / $55.52	Professional		$17.13	$19.30	$55.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.44 / $7.62 / $17.00	Professional	26	$5.44	$7.62	$17.00
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $25.70 / $83.28 / $83.28	Professional	50	$25.70	$83.28	$83.28
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.53 / $17.53 / $18.69	Professional	TC	$17.53	$17.53	$18.69
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 $41.00 / $41.00 / $41.00	Professional		$41.00	$41.00	$41.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.08 / $67.59 / $103.23	Facility		$21.08	$67.59	$103.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.07 / $36.67 / $51.15	Professional		$22.07	$36.67	$51.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.30 / $11.78 / $15.19	Professional	26	$6.30	$11.78	$15.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.24 / $25.05 / $36.36	Professional	TC	$15.24	$25.05	$36.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.20 / $32.34 / $32.34	Professional		$6.20	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $20.99 / $29.63 / $53.15	Professional		$20.99	$29.63	$53.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.35 / $8.97 / $16.27	Professional	26	$6.35	$8.97	$16.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.31 / $20.62 / $36.88	Professional	TC	$14.31	$20.62	$36.88