Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.30 / $347.70 / $759.20	Facility		$95.30	$347.70	$759.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.03 / $40.60 / $79.68	Facility	26	$33.03	$40.60	$79.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.08 / $146.10 / $250.00	Professional		$101.08	$146.10	$250.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.28 / $50.57 / $106.69	Professional	26	$33.28	$50.57	$106.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.68 / $95.04 / $148.21	Professional	TC	$65.68	$95.04	$148.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.61 / $80.09 / $155.86	Professional		$77.61	$80.09	$155.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.08 / $30.28 / $59.82	Professional	26	$28.08	$30.28	$59.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $51.04 / $53.61 / $60.82	Professional	TC	$51.04	$53.61	$60.82
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 $210.00 / $210.00 / $210.00	Professional		$210.00	$210.00	$210.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.92 / $110.39 / $153.08	Facility		$86.92	$110.39	$153.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.57 / $159.80 / $261.11	Professional		$95.57	$159.80	$261.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.43 / $55.04 / $77.73	Professional	26	$32.43	$55.04	$77.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.14 / $106.28 / $170.98	Professional	TC	$63.14	$106.28	$170.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $59.20	Professional		$32.34	$32.34	$59.20
United Facility/Professional Professional Modifier Low / Median / High Price $101.02 / $132.82 / $222.47	Professional		$101.02	$132.82	$222.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.24 / $44.97 / $80.44	Professional	26	$32.24	$44.97	$80.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.69 / $85.49 / $141.72	Professional	TC	$66.69	$85.49	$141.72