Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.06 / $277.80 / $706.75	Facility		$96.06	$277.80	$706.75
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.10 / $56.96 / $87.00	Facility	26	$30.10	$56.96	$87.00
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $61.07 / $138.28 / $450.80	Facility	TC	$61.07	$138.28	$450.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.92 / $139.61 / $245.91	Professional		$92.92	$139.61	$245.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.35 / $36.97 / $83.69	Professional	26	$30.35	$36.97	$83.69
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $45.59 / $69.81 / $105.47	Professional	52	$45.59	$69.81	$105.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.08 / $92.53 / $138.28	Professional	TC	$61.08	$92.53	$138.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.92 / $92.40 / $99.79	Professional		$73.92	$92.40	$99.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.59 / $32.10 / $60.93	Professional	26	$25.59	$32.10	$60.93
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $41.00 / $48.24 / $60.30	Professional	TC	$41.00	$48.24	$60.30
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 $204.00 / $204.00 / $204.00	Professional		$204.00	$204.00	$204.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $92.57 / $110.39 / $153.08	Facility		$92.57	$110.39	$153.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.97 / $150.59 / $244.58	Professional		$81.97	$150.59	$244.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.58 / $49.86 / $71.03	Professional	26	$28.58	$49.86	$71.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.38 / $95.95 / $159.12	Professional	TC	$53.38	$95.95	$159.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $55.47	Professional		$32.34	$32.34	$55.47
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 $93.31 / $120.89 / $206.68	Professional		$93.31	$120.89	$206.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.31 / $40.60 / $72.70	Professional	26	$29.31	$40.60	$72.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.66 / $79.56 / $141.55	Professional	TC	$62.66	$79.56	$141.55