Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $217.73 / $414.90 / $887.40	Facility		$217.73	$414.90	$887.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.47 / $43.91 / $73.92	Facility	26	$39.47	$43.91	$73.92
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $87.09 / $286.00 / $938.18	Facility	TC	$87.09	$286.00	$938.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.68 / $258.70 / $436.61	Professional		$198.68	$258.70	$436.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.05 / $43.58 / $73.92	Professional	26	$30.05	$43.58	$73.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.77 / $215.46 / $362.69	Professional	TC	$169.77	$215.46	$362.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.94 / $184.88 / $230.47	Professional		$158.94	$184.88	$230.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.99 / $33.97 / $50.84	Professional	26	$26.99	$33.97	$50.84
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $111.99 / $131.76 / $139.99	Professional	TC	$111.99	$131.76	$139.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.00 / $338.00 / $338.00	Professional		$338.00	$338.00	$338.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $205.43 / $252.77 / $2,186.00	Facility		$205.43	$252.77	$2,186.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.52 / $320.83 / $449.14	Professional		$216.52	$320.83	$449.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.22 / $45.51 / $58.07	Professional	26	$35.22	$45.51	$58.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $182.37 / $280.27 / $373.69	Professional	TC	$182.37	$280.27	$373.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $153.06	Professional		$32.34	$32.34	$153.06
United Facility/Professional Professional Modifier Low / Median / High Price $208.88 / $294.69 / $431.10	Professional		$208.88	$294.69	$431.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.82 / $40.67 / $65.59	Professional	26	$31.82	$40.67	$65.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.52 / $263.79 / $369.69	Professional	TC	$181.52	$263.79	$369.69