Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $150.71 / $150.71 / $301.42	Facility		$150.71	$150.71	$301.42
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $183.42 / $183.42 / $183.42	Facility	TC	$183.42	$183.42	$183.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.05 / $170.00 / $201.54	Professional		$81.05	$170.00	$201.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.43 / $45.82 / $50.83	Professional	26	$20.43	$45.82	$50.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.62 / $120.78 / $150.71	Professional	TC	$60.62	$120.78	$150.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.27 / $59.27 / $297.00	Professional		$59.27	$59.27	$297.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.86 / $14.86 / $59.45	Professional	26	$14.86	$14.86	$59.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $49.29 / $49.29 / $49.29	Professional	TC	$49.29	$49.29	$49.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.18 / $134.18 / $134.18	Professional		$134.18	$134.18	$134.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.29 / $84.88 / $169.66	Professional		$43.29	$84.88	$169.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.36 / $29.12 / $52.95	Professional	26	$12.36	$29.12	$52.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.92 / $61.06 / $119.91	Professional	TC	$33.92	$61.06	$119.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $55.08 / $117.91 / $235.81	Professional		$55.08	$117.91	$235.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.20 / $30.57 / $61.68	Professional	26	$16.20	$30.57	$61.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.69 / $83.90 / $139.41	Professional	TC	$38.69	$83.90	$139.41