Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $295.12 / $645.65	Facility		$93.33	$295.12	$645.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $25.70 / $123.03	Facility	26	$23.99	$25.70	$123.03
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $50.12 / $208.93 / $407.38	Facility	TC	$50.12	$208.93	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $107.15 / $199.53	Professional		$74.13	$107.15	$199.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $33.11 / $77.62	Professional	26	$23.99	$33.11	$77.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $67.61 / $117.49	Professional	TC	$48.98	$67.61	$117.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $67.61 / $87.10	Professional		$53.70	$67.61	$87.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $26.30 / $43.65	Professional	26	$20.89	$26.30	$43.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $47.86 / $60.26	Professional	TC	$35.48	$47.86	$60.26
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 $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $109.65 / $151.36	Facility		$93.33	$109.65	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $114.82 / $186.21	Professional		$63.10	$114.82	$186.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $38.02 / $57.54	Professional	26	$20.89	$38.02	$57.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $75.86 / $128.82	Professional	TC	$41.69	$75.86	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $43.65	Professional		$32.36	$33.11	$43.65
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 $72.44 / $93.33 / $158.49	Professional		$72.44	$93.33	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $30.20 / $53.70	Professional	26	$23.99	$30.20	$53.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $63.10 / $100.00	Professional	TC	$47.86	$63.10	$100.00