Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.88 / $98.00 / $115.27	Facility	26	$60.88	$98.00	$115.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.88 / $271.92 / $325.00	Professional		$152.88	$271.92	$325.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.69 / $51.59 / $115.27	Professional	26	$45.69	$51.59	$115.27
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $76.44 / $135.96 / $162.50	Professional	52	$76.44	$135.96	$162.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $92.00 / $174.20 / $227.00	Professional	TC	$92.00	$174.20	$227.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.28 / $116.62 / $268.23	Professional		$94.28	$116.62	$268.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.54 / $46.92 / $117.30	Professional	26	$37.54	$46.92	$117.30
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $78.06 / $78.06 / $78.06	Professional	TC	$78.06	$78.06	$78.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $307.14 / $307.14 / $307.14	Professional		$307.14	$307.14	$307.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.41 / $277.02 / $433.10	Professional		$112.41	$277.02	$433.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.53 / $86.16 / $114.51	Professional	26	$43.53	$86.16	$114.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.88 / $193.65 / $343.21	Professional	TC	$68.88	$193.65	$343.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $104.96	Professional		$32.34	$32.34	$104.96
United Facility/Professional Professional Modifier Low / Median / High Price $142.78 / $177.40 / $431.07	Professional		$142.78	$177.40	$431.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.87 / $67.31 / $112.18	Professional	26	$44.87	$67.31	$112.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.52 / $136.77 / $333.49	Professional	TC	$89.52	$136.77	$333.49