Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.59 / $145.86 / $258.31	Facility		$32.59	$145.86	$258.31
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.50 / $9.23 / $18.11	Facility	26	$7.50	$9.23	$18.11
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.61 / $39.60 / $364.76	Facility	TC	$17.61	$39.60	$364.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.91 / $28.94 / $57.70	Professional		$23.91	$28.94	$57.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.00 / $8.49 / $20.00	Professional	26	$8.00	$8.49	$20.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.39 / $20.04 / $39.60	Professional	TC	$16.39	$20.04	$39.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.49 / $22.20 / $58.90	Professional		$20.49	$22.20	$58.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.40 / $8.13 / $20.00	Professional	26	$6.40	$8.13	$20.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.09 / $17.80 / $22.45	Professional	TC	$14.09	$17.80	$22.45
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 $43.00 / $43.00 / $43.00	Professional		$43.00	$43.00	$43.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.59 / $68.78 / $78.61	Facility		$67.59	$68.78	$78.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.95 / $36.44 / $51.13	Professional		$22.95	$36.44	$51.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.43 / $13.41 / $17.96	Professional	26	$7.43	$13.41	$17.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.69 / $24.86 / $32.95	Professional	TC	$15.69	$24.86	$32.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.29 / $32.34 / $32.34	Professional		$7.29	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $20.87 / $31.70 / $53.50	Professional		$20.87	$31.70	$53.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.18 / $10.34 / $19.91	Professional	26	$7.18	$10.34	$19.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.34 / $20.62 / $36.95	Professional	TC	$13.34	$20.62	$36.95