Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.84 / $225.60 / $591.57	Facility		$93.84	$225.60	$591.57
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.28 / $33.27 / $56.29	Facility	26	$23.28	$33.27	$56.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.48 / $131.79 / $215.05	Professional		$96.48	$131.79	$215.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.28 / $33.60 / $57.60	Professional	26	$23.28	$33.60	$57.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $46.92 / $67.63 / $107.53	Professional	52	$46.92	$67.63	$107.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.19 / $94.28 / $158.75	Professional	TC	$70.19	$94.28	$158.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $85.74 / $147.33	Professional		$73.20	$85.74	$147.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.66 / $24.65 / $46.79	Professional	26	$19.66	$24.65	$46.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $54.63 / $61.68 / $81.95	Professional	TC	$54.63	$61.68	$81.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $241.89 / $241.89 / $266.08	Facility		$241.89	$241.89	$266.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $174.00 / $174.00 / $174.00	Professional		$174.00	$174.00	$174.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $92.57 / $110.39 / $153.08	Facility		$92.57	$110.39	$153.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.37 / $139.65 / $224.79	Professional		$79.37	$139.65	$224.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.63 / $37.29 / $53.62	Professional	26	$22.63	$37.29	$53.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.38 / $103.93 / $171.17	Professional	TC	$60.38	$103.93	$171.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $63.25	Professional		$32.34	$32.34	$63.25
United Facility/Professional Facility Modifier Low / Median / High Price $174.35 / $174.35 / $174.35	Facility		$174.35	$174.35	$174.35
United Facility/Professional Professional Modifier Low / Median / High Price $83.31 / $117.93 / $198.10	Professional		$83.31	$117.93	$198.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.23 / $30.31 / $54.76	Professional	26	$22.23	$30.31	$54.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.54 / $89.14 / $147.47	Professional	TC	$61.54	$89.14	$147.47