Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $138.04 / $234.42	Professional		$112.20	$138.04	$234.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $23.99 / $41.69	Professional	26	$12.88	$23.99	$41.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $117.49 / $190.55	Professional	TC	$95.50	$117.49	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $100.00 / $125.89	Professional		$97.72	$100.00	$125.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $21.88 / $30.20	Professional	26	$19.50	$21.88	$30.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $275.42 / $275.42	Professional		$100.00	$275.42	$275.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $181.97 / $281.84	Professional		$131.83	$181.97	$281.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $23.99 / $39.81	Professional	26	$15.14	$23.99	$39.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $154.88 / $245.47	Professional	TC	$112.20	$154.88	$245.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $257.04	Professional		$125.89	$162.18	$257.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $22.91 / $36.31	Professional	26	$14.13	$22.91	$36.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $141.25 / $234.42	Professional	TC	$107.15	$141.25	$234.42