Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $210.31 / $408.17 / $1,314.18	Facility		$210.31	$408.17	$1,314.18
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.74 / $47.00 / $63.45	Facility	26	$33.74	$47.00	$63.45
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $167.71 / $320.02 / $604.52	Facility	TC	$167.71	$320.02	$604.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.68 / $260.75 / $298.26	Professional		$198.68	$260.75	$298.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.05 / $43.91 / $49.35	Professional	26	$30.05	$43.91	$49.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $167.12 / $219.21 / $248.91	Professional	TC	$167.12	$219.21	$248.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $161.16 / $171.23 / $271.95	Professional		$161.16	$171.23	$271.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.99 / $33.74 / $45.55	Professional	26	$26.99	$33.74	$45.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $226.41 / $226.41 / $226.41	Professional	TC	$226.41	$226.41	$226.41
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 $175.51 / $240.43 / $283.70	Professional		$175.51	$240.43	$283.70
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.05 / $38.42 / $45.34	Professional	26	$28.05	$38.42	$45.34
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $147.47 / $202.01 / $238.37	Professional	TC	$147.47	$202.01	$238.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $226.05 / $351.65 / $629.01	Facility		$226.05	$351.65	$629.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.10 / $268.06 / $627.30	Professional		$182.10	$268.06	$627.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.02 / $38.75 / $101.00	Professional	26	$29.02	$38.75	$101.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.49 / $237.35 / $581.71	Professional	TC	$162.49	$237.35	$581.71
United Facility/Professional Professional Modifier Low / Median / High Price $190.58 / $232.88 / $375.42	Professional		$190.58	$232.88	$375.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.46 / $34.78 / $51.57	Professional	26	$29.46	$34.78	$51.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.65 / $199.02 / $343.51	Professional	TC	$159.65	$199.02	$343.51