Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $107.15 / $107.15	Facility	26	$64.57	$107.15	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $407.38 / $891.25	Professional		$208.93	$407.38	$891.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $112.20 / $208.93	Professional	26	$66.07	$112.20	$208.93
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $158.49 / $512.86 / $549.54	Professional	52	$158.49	$512.86	$549.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $257.04 / $562.34	Professional	TC	$125.89	$257.04	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $154.88 / $295.12	Professional		$128.82	$154.88	$295.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $77.62 / $97.72	Professional	26	$54.95	$77.62	$97.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $93.33 / $645.65	Professional	TC	$79.43	$93.33	$645.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $416.87 / $501.19	Professional		$154.88	$416.87	$501.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $162.18 / $190.55	Professional	26	$81.28	$162.18	$190.55
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $263.03 / $309.03	Professional	TC	$95.50	$263.03	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $398.11 / $645.65	Professional		$190.55	$398.11	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $112.20 / $186.21	Professional	26	$72.44	$112.20	$186.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $281.84 / $501.19	Professional	TC	$128.82	$281.84	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $239.88 / $660.69	Professional		$165.96	$239.88	$660.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $74.13 / $117.49	Professional	26	$56.23	$74.13	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $154.88 / $537.03	Professional	TC	$107.15	$154.88	$537.03