Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $436.52 / $933.25	Facility		$208.93	$436.52	$933.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $38.02 / $75.86	Facility	26	$34.67	$38.02	$75.86
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $158.49 / $288.40 / $954.99	Facility	TC	$158.49	$288.40	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $234.42 / $380.19	Professional		$173.78	$234.42	$380.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $40.74 / $75.86	Professional	26	$30.20	$40.74	$75.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $177.83 / $309.03	Professional	TC	$141.25	$177.83	$309.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $141.25 / $223.87	Professional		$114.82	$141.25	$223.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $31.62 / $50.12	Professional	26	$24.55	$31.62	$50.12
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $123.03 / $154.88	Professional	TC	$97.72	$123.03	$154.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Professional		$257.04	$257.04	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $263.03 / $3,467.37	Facility		$204.17	$263.03	$3,467.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $251.19 / $354.81	Professional		$169.82	$251.19	$354.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $44.67 / $61.66	Professional	26	$30.90	$44.67	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $204.17 / $323.59	Professional	TC	$138.04	$204.17	$323.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $112.20	Professional		$32.36	$33.11	$112.20
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 $162.18 / $218.78 / $338.84	Professional		$162.18	$218.78	$338.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $37.15 / $56.23	Professional	26	$30.20	$37.15	$56.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $181.97 / $295.12	Professional	TC	$131.83	$181.97	$295.12