Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $501.19	Facility		$138.04	$138.04	$501.19
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $28.84 / $28.84	Facility	26	$28.84	$28.84	$28.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $141.25 / $275.42	Professional		$107.15	$141.25	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $28.84 / $57.54	Professional	26	$20.89	$28.84	$57.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $107.15 / $177.83	Professional	TC	$83.18	$107.15	$177.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $17.78 / $28.18	Professional	26	$17.78	$17.78	$28.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $181.97 / $245.47	Facility		$151.36	$181.97	$245.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $147.91 / $162.18	Professional		$91.20	$147.91	$162.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $31.62 / $34.67	Professional	26	$19.05	$31.62	$34.67
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $114.82 / $125.89	Professional	TC	$72.44	$114.82	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $162.18 / $281.84	Facility		$112.20	$162.18	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $151.36 / $316.23	Professional		$89.13	$151.36	$316.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $26.92 / $63.10	Professional	26	$19.05	$26.92	$63.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $131.83 / $263.03	Professional	TC	$85.11	$131.83	$263.03
United Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $117.49 / $162.18	Facility		$20.42	$117.49	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $120.23 / $204.17	Professional		$93.33	$120.23	$204.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $23.99 / $33.11	Professional	26	$19.05	$23.99	$33.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $95.50 / $177.83	Professional	TC	$74.13	$95.50	$177.83