Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.64 / $234.60 / $636.00	Facility		$43.64	$234.60	$636.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.97 / $10.85 / $14.66	Facility	26	$8.97	$10.85	$14.66
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.78 / $311.26 / $721.78	Facility	TC	$32.78	$311.26	$721.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.13 / $32.11 / $45.83	Professional		$26.13	$32.11	$45.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.93 / $8.55 / $11.40	Professional	26	$6.93	$8.55	$11.40
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.55 / $16.05 / $21.83	Professional	52	$12.55	$16.05	$21.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.52 / $23.06 / $34.42	Professional	TC	$19.52	$23.06	$34.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.10 / $34.64 / $38.69	Professional		$23.10	$34.64	$38.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.90 / $7.41 / $13.32	Professional	26	$5.90	$7.41	$13.32
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $34.25 / $51.97 / $51.97	Professional	50	$34.25	$51.97	$51.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.46 / $18.55 / $19.12	Professional	TC	$17.46	$18.55	$19.12
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 $32.49 / $44.50 / $52.51	Professional		$32.49	$44.50	$52.51
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 $22.49 / $30.81 / $36.36	Professional	TC	$22.49	$30.81	$36.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.46 / $108.05 / $202.38	Facility		$38.46	$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 $20.58 / $20.58 / $20.76	Facility	TC	$20.58	$20.58	$20.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.38 / $34.00 / $71.66	Professional		$23.38	$34.00	$71.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.49 / $10.63 / $23.00	Professional	26	$6.49	$10.63	$23.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.88 / $25.40 / $61.37	Professional	TC	$17.88	$25.40	$61.37
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 $23.36 / $30.88 / $39.84	Professional		$23.36	$30.88	$39.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.50 / $8.23 / $11.60	Professional	26	$6.50	$8.23	$11.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.18 / $22.09 / $29.45	Professional	TC	$16.18	$22.09	$29.45