Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $304.05 / $390.50 / $781.00	Facility		$304.05	$390.50	$781.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.25 / $91.25 / $91.25	Facility	26	$91.25	$91.25	$91.25
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $174.74 / $174.74 / $212.80	Facility	TC	$174.74	$174.74	$212.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.93 / $263.58 / $304.05	Professional		$198.93	$263.58	$304.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.07 / $81.70 / $91.25	Professional	26	$61.07	$81.70	$91.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.18 / $181.87 / $212.80	Professional	TC	$131.18	$181.87	$212.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.91 / $123.91 / $142.49	Professional		$123.91	$123.91	$142.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.54 / $87.42 / $96.82	Professional	26	$36.54	$87.42	$96.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $304.99 / $304.99 / $359.89	Professional		$304.99	$304.99	$359.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $148.16 / $155.22 / $183.16	Professional	26	$148.16	$155.22	$183.16
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $149.77 / $149.77 / $176.73	Professional	TC	$149.77	$149.77	$176.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $145.97 / $286.51	Professional		$112.20	$145.97	$286.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.47 / $42.10 / $187.14	Professional	26	$37.47	$42.10	$187.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.06 / $97.47 / $197.97	Professional	TC	$81.06	$97.47	$197.97
United Facility/Professional Professional Modifier Low / Median / High Price $153.74 / $168.90 / $290.91	Professional		$153.74	$168.90	$290.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.90 / $63.03 / $86.62	Professional	26	$49.90	$63.03	$86.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.61 / $116.93 / $194.88	Professional	TC	$91.61	$116.93	$194.88