Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.81 / $187.82 / $714.00	Facility		$93.81	$187.82	$714.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.08 / $47.07 / $63.55	Facility	26	$39.08	$47.07	$63.55
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $61.91 / $259.95 / $460.43	Facility	TC	$61.91	$259.95	$460.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.92 / $119.64 / $146.59	Professional		$82.92	$119.64	$146.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.26 / $33.70 / $49.43	Professional	26	$27.26	$33.70	$49.43
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $35.94 / $51.74 / $69.81	Professional	52	$35.94	$51.74	$69.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.99 / $87.95 / $97.15	Professional	TC	$48.99	$87.95	$97.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.47 / $80.54 / $126.04	Professional		$70.47	$80.54	$126.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.68 / $38.19 / $42.39	Professional	26	$25.68	$38.19	$42.39
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $52.16 / $82.85 / $82.85	Professional	TC	$52.16	$82.85	$82.85
BCBS Facility/Professional Facility Modifier Low / Median / High Price $224.09 / $271.27 / $364.97	Facility		$224.09	$271.27	$364.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.96 / $152.00 / $179.36	Professional		$110.96	$152.00	$179.36
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.90 / $77.00 / $90.86	Professional	26	$53.90	$77.00	$90.86
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.75 / $75.00 / $88.50	Professional	TC	$54.75	$75.00	$88.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.38 / $160.88 / $276.72	Facility		$111.38	$160.88	$276.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.86 / $40.86 / $40.86	Facility	26	$40.86	$40.86	$40.86
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $89.30 / $89.30 / $89.30	Facility	TC	$89.30	$89.30	$89.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.07 / $131.68 / $306.04	Professional		$84.07	$131.68	$306.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.14 / $42.42 / $102.32	Professional	26	$28.14	$42.42	$102.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.93 / $88.92 / $206.26	Professional	TC	$55.93	$88.92	$206.26
United Facility/Professional Facility Modifier Low / Median / High Price $98.07 / $217.94 / $224.16	Facility		$98.07	$217.94	$224.16
United Facility/Professional Professional Modifier Low / Median / High Price $84.04 / $105.05 / $161.28	Professional		$84.04	$105.05	$161.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.15 / $35.54 / $48.66	Professional	26	$28.15	$35.54	$48.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.45 / $69.84 / $114.21	Professional	TC	$57.45	$69.84	$114.21