Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.17 / $120.42 / $178.90	Facility	26	$111.17	$120.42	$178.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $315.12 / $473.30 / $636.50	Professional		$315.12	$473.30	$636.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.06 / $140.00 / $178.90	Professional	26	$66.06	$140.00	$178.90
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $157.56 / $202.07 / $237.50	Professional	52	$157.56	$202.07	$237.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $198.15 / $294.39 / $368.50	Professional	TC	$198.15	$294.39	$368.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.15 / $166.68 / $289.00	Professional		$130.15	$166.68	$289.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.59 / $64.48 / $125.95	Professional	26	$51.59	$64.48	$125.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $85.84 / $85.84 / $85.84	Professional	TC	$85.84	$85.84	$85.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $476.13 / $476.13 / $476.13	Professional		$476.13	$476.13	$476.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.38 / $384.42 / $789.04	Professional		$161.38	$384.42	$789.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.60 / $120.00 / $153.96	Professional	26	$59.60	$120.00	$153.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $101.79 / $242.24 / $663.00	Professional	TC	$101.79	$242.24	$663.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $150.01	Professional		$32.34	$32.34	$150.01
United Facility/Professional Professional Modifier Low / Median / High Price $191.84 / $271.31 / $860.15	Professional		$191.84	$271.31	$860.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.20 / $84.03 / $160.93	Professional	26	$63.20	$84.03	$160.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.45 / $176.17 / $632.11	Professional	TC	$123.45	$176.17	$632.11