Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.40 / $110.50 / $164.18	Facility	26	$102.40	$110.50	$164.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.15 / $475.00 / $608.00	Professional		$165.15	$475.00	$608.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.62 / $140.00 / $164.18	Professional	26	$60.62	$140.00	$164.18
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $166.52 / $212.60 / $248.99	Professional	52	$166.52	$212.60	$248.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $224.67 / $333.79 / $368.50	Professional	TC	$224.67	$333.79	$368.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $146.57 / $177.09 / $407.31	Professional		$146.57	$177.09	$407.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.15 / $58.94 / $115.07	Professional	26	$47.15	$58.94	$115.07
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $610.96 / $610.96 / $610.96	Professional	50	$610.96	$610.96	$610.96
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $99.19 / $99.19 / $99.19	Professional	TC	$99.19	$99.19	$99.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $501.83 / $501.83 / $501.83	Professional		$501.83	$501.83	$501.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $171.29 / $400.00 / $824.33	Professional		$171.29	$400.00	$824.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.74 / $104.68 / $133.86	Professional	26	$54.74	$104.68	$133.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $116.56 / $266.77 / $692.76	Professional	TC	$116.56	$266.77	$692.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $159.38	Professional		$32.34	$32.34	$159.38
United Facility/Professional Professional Modifier Low / Median / High Price $205.68 / $326.89 / $830.52	Professional		$205.68	$326.89	$830.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.29 / $77.41 / $140.24	Professional	26	$54.29	$77.41	$140.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $139.38 / $199.17 / $664.62	Professional	TC	$139.38	$199.17	$664.62