Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $331.13 / $758.58	Facility		$95.50	$331.13	$758.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $36.31 / $162.18	Facility	26	$33.11	$36.31	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $134.90 / $251.19	Professional		$100.00	$134.90	$251.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $43.65 / $109.65	Professional	26	$33.11	$43.65	$109.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $85.11 / $154.88	Professional	TC	$64.57	$85.11	$154.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $83.18 / $117.49	Professional		$70.79	$83.18	$117.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $36.31 / $70.79	Professional	26	$28.18	$36.31	$70.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $58.88 / $79.43	Professional	TC	$47.86	$58.88	$79.43
BCBS Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $269.15	Facility		$239.88	$239.88	$269.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $97.72 / $151.36	Facility		$87.10	$97.72	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $154.88 / $245.47	Professional		$85.11	$154.88	$245.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $53.70 / $79.43	Professional	26	$28.84	$53.70	$79.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $100.00 / $165.96	Professional	TC	$54.95	$100.00	$165.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $57.54	Professional		$32.36	$33.11	$57.54
United Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $208.93 / $223.87	Facility		$120.23	$208.93	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $125.89 / $213.80	Professional		$100.00	$125.89	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $41.69 / $75.86	Professional	26	$33.11	$41.69	$75.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $83.18 / $138.04	Professional	TC	$64.57	$83.18	$138.04