Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.56 / $190.20 / $361.06	Facility		$77.56	$190.20	$361.06
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.92 / $8.52 / $21.00	Facility	26	$6.92	$8.52	$21.00
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.47 / $48.90 / $361.06	Facility	TC	$21.47	$48.90	$361.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.38 / $35.86 / $65.65	Professional		$22.38	$35.86	$65.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.55 / $29.30	Professional	26	$7.33	$8.55	$29.30
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $62.13 / $81.00 / $114.54	Professional	50	$62.13	$81.00	$114.54
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.70 / $23.89 / $32.83	Professional	52	$13.70	$23.89	$32.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.46 / $24.28 / $42.30	Professional	TC	$20.46	$24.28	$42.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.10 / $24.54 / $66.40	Professional		$23.10	$24.54	$66.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.92 / $7.40 / $18.50	Professional	26	$5.92	$7.40	$18.50
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $34.65 / $40.13 / $99.60	Professional	50	$34.65	$40.13	$99.60
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.18 / $21.72 / $24.05	Professional	TC	$17.18	$21.72	$24.05
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 $45.00 / $45.00 / $45.00	Professional		$45.00	$45.00	$45.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.40 / $67.59 / $103.23	Facility		$25.40	$67.59	$103.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.71 / $40.69 / $59.14	Professional		$25.71	$40.69	$59.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.87 / $12.82 / $16.57	Professional	26	$6.87	$12.82	$16.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.16 / $28.91 / $43.03	Professional	TC	$18.16	$28.91	$43.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.74 / $32.34 / $32.34	Professional		$6.74	$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 $22.86 / $34.86 / $60.55	Professional		$22.86	$34.86	$60.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.65 / $9.78 / $17.87	Professional	26	$6.65	$9.78	$17.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.80 / $24.73 / $42.68	Professional	TC	$15.80	$24.73	$42.68