Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.53 / $289.80 / $680.46	Facility		$93.53	$289.80	$680.46
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.19 / $34.58 / $58.50	Facility	26	$24.19	$34.58	$58.50
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $49.42 / $111.59 / $456.27	Facility	TC	$49.42	$111.59	$456.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.38 / $118.44 / $185.00	Professional		$75.38	$118.44	$185.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.50 / $35.28 / $66.59	Professional	26	$24.50	$35.28	$66.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.43 / $74.69 / $111.59	Professional	TC	$49.43	$74.69	$111.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.51 / $74.37 / $116.34	Professional		$61.51	$74.37	$116.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.44 / $25.62 / $38.54	Professional	26	$20.44	$25.62	$38.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $39.00 / $40.95 / $58.50	Professional	TC	$39.00	$40.95	$58.50
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 $142.00 / $142.00 / $142.00	Professional		$142.00	$142.00	$142.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $92.57 / $110.57 / $153.08	Facility		$92.57	$110.57	$153.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.09 / $118.36 / $196.74	Professional		$66.09	$118.36	$196.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.87 / $39.68 / $56.90	Professional	26	$22.87	$39.68	$56.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.24 / $77.86 / $128.72	Professional	TC	$43.24	$77.86	$128.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $44.92	Professional		$32.34	$32.34	$44.92
United Facility/Professional Facility Modifier Low / Median / High Price $174.35 / $174.35 / $174.35	Facility		$174.35	$174.35	$174.35
United Facility/Professional Professional Modifier Low / Median / High Price $74.20 / $96.64 / $160.65	Professional		$74.20	$96.64	$160.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.25 / $32.31 / $61.05	Professional	26	$23.25	$32.31	$61.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.11 / $64.37 / $106.76	Professional	TC	$49.11	$64.37	$106.76