Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.00 / $162.38 / $681.72	Facility		$78.00	$162.38	$681.72
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.45 / $43.45 / $58.65	Facility	26	$43.45	$43.45	$58.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.24 / $81.01 / $114.46	Professional		$56.24	$81.01	$114.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.05 / $31.41 / $45.62	Professional	26	$22.05	$31.41	$45.62
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $45.67 / $45.67 / $423.00	Professional	50	$45.67	$45.67	$423.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.68 / $50.56 / $68.83	Professional	TC	$34.68	$50.56	$68.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.52 / $74.09 / $152.59	Professional		$63.52	$74.09	$152.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.81 / $32.86 / $53.78	Professional	26	$23.81	$32.86	$53.78
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $95.28 / $95.28 / $228.89	Professional	50	$95.28	$95.28	$228.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $58.40 / $58.40 / $58.40	Professional	TC	$58.40	$58.40	$58.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.62 / $178.55 / $240.41	Facility		$147.62	$178.55	$240.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.23 / $85.25 / $100.60	Professional		$62.23	$85.25	$100.60
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.08 / $34.35 / $40.53	Professional	26	$25.08	$34.35	$40.53
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $50.90 / $60.06	Professional	TC	$37.15	$50.90	$60.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $78.18 / $132.28 / $229.12	Facility		$78.18	$132.28	$229.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.59 / $99.63 / $237.03	Professional		$64.59	$99.63	$237.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.22 / $43.20 / $100.22	Professional	26	$26.22	$43.20	$100.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.79 / $63.10 / $150.07	Professional	TC	$40.79	$63.10	$150.07
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 $65.06 / $81.70 / $119.07	Professional		$65.06	$81.70	$119.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.99 / $33.33 / $46.31	Professional	26	$25.99	$33.33	$46.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.00 / $48.38 / $72.37	Professional	TC	$39.00	$48.38	$72.37