Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $398.11 / $812.83	Facility		$218.78	$398.11	$812.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $39.81 / $70.79	Facility	26	$39.81	$39.81	$70.79
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $173.78 / $288.40 / $870.96	Facility	TC	$173.78	$288.40	$870.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $269.15 / $467.74	Professional		$204.17	$269.15	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $39.81 / $79.43	Professional	26	$33.11	$39.81	$79.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $229.09 / $416.87	Professional	TC	$181.97	$229.09	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $181.97 / $229.09	Professional		$141.25	$181.97	$229.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $34.67 / $52.48	Professional	26	$28.18	$34.67	$52.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $162.18 / $213.80	Professional	TC	$117.49	$162.18	$213.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Professional		$338.84	$338.84	$338.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $331.13 / $3,467.37	Facility		$204.17	$331.13	$3,467.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $316.23 / $457.09	Professional		$218.78	$316.23	$457.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $44.67 / $63.10	Professional	26	$33.88	$44.67	$63.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $275.42 / $416.87	Professional	TC	$181.97	$275.42	$416.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $147.91	Professional		$32.36	$33.11	$147.91
United Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $426.58 / $630.96	Facility		$269.15	$426.58	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $269.15 / $416.87	Professional		$208.93	$269.15	$416.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $38.90 / $60.26	Professional	26	$31.62	$38.90	$60.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $234.42 / $380.19	Professional	TC	$173.78	$234.42	$380.19