Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $120.23 / $186.21	Facility	26	$112.20	$120.23	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $416.87 / $812.83	Professional		$204.17	$416.87	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $112.20 / $223.87	Professional	26	$64.57	$112.20	$223.87
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $123.03 / $562.34 / $562.34	Professional	52	$123.03	$562.34	$562.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $204.17 / $436.52	Professional	TC	$123.03	$204.17	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $147.91 / $288.40	Professional		$112.20	$147.91	$288.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $64.57 / $112.20	Professional	26	$52.48	$64.57	$112.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $95.50 / $177.83	Professional	TC	$79.43	$95.50	$177.83
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 $162.18 / $398.11 / $794.33	Professional		$162.18	$398.11	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $117.49 / $154.88	Professional	26	$52.48	$117.49	$154.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $269.15 / $660.69	Professional	TC	$102.33	$269.15	$660.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $91.20	Professional		$32.36	$33.11	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $263.03 / $851.14	Professional		$181.97	$263.03	$851.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $83.18 / $158.49	Professional	26	$63.10	$83.18	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $173.78 / $676.08	Professional	TC	$120.23	$173.78	$676.08