Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $194.98 / $758.58	Facility		$95.50	$194.98	$758.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $36.31 / $36.31	Facility	26	$25.12	$36.31	$36.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $162.18 / $288.40	Professional		$91.20	$162.18	$288.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $48.98 / $70.79	Professional	26	$22.91	$48.98	$70.79
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.18 / $109.65 / $239.88	Professional	52	$28.18	$109.65	$239.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $95.50 / $199.53	Professional	TC	$66.07	$95.50	$199.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $85.11 / $147.91	Professional		$75.86	$85.11	$147.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $28.18 / $38.02	Professional	26	$20.42	$28.18	$38.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $61.66 / $112.20	Professional	TC	$46.77	$61.66	$112.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $181.97 / $245.47	Facility		$151.36	$181.97	$245.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $141.25 / $154.88	Professional		$87.10	$141.25	$154.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $35.48 / $38.90	Professional	26	$24.55	$35.48	$38.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $104.71 / $114.82	Professional	TC	$64.57	$104.71	$114.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $165.96 / $275.42	Facility		$109.65	$165.96	$275.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $30.20 / $30.20	Facility	26	$30.20	$30.20	$30.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $128.82 / $275.42	Professional		$85.11	$128.82	$275.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $35.48 / $79.43	Professional	26	$25.12	$35.48	$79.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $109.65 / $229.09	Professional	TC	$67.61	$109.65	$229.09
United Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $169.82 / $223.87	Facility		$60.26	$169.82	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $107.15 / $144.54	Professional		$77.62	$107.15	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $26.92 / $38.90	Professional	26	$21.88	$26.92	$38.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $79.43 / $107.15	Professional	TC	$57.54	$79.43	$107.15