Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.17 / $160.19 / $381.80	Facility		$78.17	$160.19	$381.80
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.01 / $40.33 / $67.00	Facility	26	$28.01	$40.33	$67.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.45 / $94.14 / $164.93	Professional		$31.45	$94.14	$164.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.01 / $42.96 / $67.00	Professional	26	$28.01	$42.96	$67.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $45.67 / $45.67 / $340.98	Professional	50	$45.67	$45.67	$340.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.20 / $59.57 / $97.93	Professional	TC	$43.20	$59.57	$97.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.17 / $65.75 / $168.18	Professional		$57.17	$65.75	$168.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.90 / $29.95 / $52.10	Professional	26	$23.90	$29.95	$52.10
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $85.75 / $98.63 / $252.26	Professional	50	$85.75	$98.63	$252.26
BCBS Facility/Professional Facility Modifier Low / Median / High Price $145.02 / $145.02 / $159.52	Facility		$145.02	$145.02	$159.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.00 / $142.00 / $142.00	Professional		$142.00	$142.00	$142.00
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 $61.65 / $109.34 / $161.22	Professional		$61.65	$109.34	$161.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.47 / $45.00 / $66.26	Professional	26	$27.47	$45.00	$66.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.15 / $64.34 / $94.97	Professional	TC	$40.15	$64.34	$94.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $39.90	Professional		$32.34	$32.34	$39.90
United Facility/Professional Facility Modifier Low / Median / High Price $129.44 / $129.44 / $129.44	Facility		$129.44	$129.44	$129.44
United Facility/Professional Professional Modifier Low / Median / High Price $68.64 / $96.66 / $178.56	Professional		$68.64	$96.66	$178.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.04 / $37.43 / $69.90	Professional	26	$27.04	$37.43	$69.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.54 / $54.49 / $102.60	Professional	TC	$38.54	$54.49	$102.60