Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $158.49 / $398.11	Facility		$77.62	$158.49	$398.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $30.20 / $120.23	Facility	26	$28.18	$30.20	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $91.20 / $186.21	Professional		$41.69	$91.20	$186.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $38.90 / $107.15	Professional	26	$28.18	$38.90	$107.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $44.67 / $91.20 / $295.12	Professional	50	$44.67	$91.20	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $56.23 / $102.33	Professional	TC	$42.66	$56.23	$102.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $81.28 / $114.82	Professional		$63.10	$81.28	$114.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $30.20 / $60.26	Professional	26	$23.99	$30.20	$60.26
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $85.11 / $112.20 / $257.04	Professional	50	$85.11	$112.20	$257.04
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $45.71 / $72.44	Professional	TC	$37.15	$45.71	$72.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $158.49	Facility		$144.54	$144.54	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $69.18 / $79.43	Facility		$67.61	$69.18	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $107.15 / $169.82	Professional		$60.26	$107.15	$169.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $44.67 / $67.61	Professional	26	$23.44	$44.67	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $64.57 / $100.00	Professional	TC	$36.31	$64.57	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $38.90	Professional		$32.36	$33.11	$38.90
United Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $158.49 / $173.78	Facility		$100.00	$158.49	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $89.13 / $158.49	Professional		$69.18	$89.13	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $34.67 / $66.07	Professional	26	$27.54	$34.67	$66.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $54.95 / $93.33	Professional	TC	$40.74	$54.95	$93.33