Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $120.23 / $177.83	Facility	26	$109.65	$120.23	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $426.58 / $660.69	Professional		$213.80	$426.58	$660.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $91.20 / $223.87	Professional	26	$64.57	$91.20	$223.87
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $112.20 / $112.20 / $112.20	Professional	52	$112.20	$112.20	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $263.03 / $436.52	Professional	TC	$138.04	$263.03	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $173.78 / $302.00	Professional		$138.04	$173.78	$302.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $66.07 / $109.65	Professional	26	$52.48	$66.07	$109.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $120.23 / $186.21	Professional	TC	$102.33	$120.23	$186.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Professional		$478.63	$478.63	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $398.11 / $870.96	Professional		$165.96	$398.11	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $114.82 / $151.36	Professional	26	$52.48	$114.82	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $281.84 / $741.31	Professional	TC	$107.15	$281.84	$741.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $97.72	Professional		$32.36	$33.11	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $269.15 / $891.25	Professional		$186.21	$269.15	$891.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $81.28 / $147.91	Professional	26	$60.26	$81.28	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $181.97 / $758.58	Professional	TC	$125.89	$181.97	$758.58