Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.22 / $254.99 / $1,022.02	Facility		$97.22	$254.99	$1,022.02
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.85 / $26.44 / $35.69	Facility	26	$23.85	$26.44	$35.69
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $89.15 / $122.84 / $489.64	Facility	TC	$89.15	$122.84	$489.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.93 / $134.93 / $165.91	Professional		$100.93	$134.93	$165.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $25.95 / $38.90	Professional	26	$19.05	$25.95	$38.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.89 / $108.60 / $133.09	Professional	TC	$81.89	$108.60	$133.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.75 / $85.80 / $134.60	Professional		$80.75	$85.80	$134.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.24 / $21.46 / $30.48	Professional	26	$15.24	$21.46	$30.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $65.51 / $110.55 / $110.55	Professional	TC	$65.51	$110.55	$110.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.62 / $178.70 / $240.41	Facility		$147.62	$178.70	$240.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.52 / $124.00 / $146.32	Professional		$90.52	$124.00	$146.32
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.66 / $24.19 / $28.54	Professional	26	$17.66	$24.19	$28.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.86 / $99.81 / $117.78	Professional	TC	$72.86	$99.81	$117.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.38 / $158.07 / $281.31	Facility		$111.38	$158.07	$281.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.12 / $126.27 / $301.70	Professional		$88.12	$126.27	$301.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.94 / $23.18 / $58.61	Professional	26	$18.94	$23.18	$58.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.88 / $108.91 / $258.41	Professional	TC	$71.88	$108.91	$258.41
United Facility/Professional Professional Modifier Low / Median / High Price $93.11 / $123.10 / $204.79	Professional		$93.11	$123.10	$204.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.05 / $21.82 / $30.12	Professional	26	$17.05	$21.82	$30.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.05 / $91.95 / $181.70	Professional	TC	$76.05	$91.95	$181.70