Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.25 / $10.15 / $22.30	Facility	26	$9.25	$10.15	$22.30
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.90 / $65.65 / $456.20	Facility	TC	$29.90	$65.65	$456.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.76 / $50.73 / $87.96	Professional		$36.76	$50.73	$87.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.39 / $11.82 / $22.30	Professional	26	$9.39	$11.82	$22.30
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $18.78 / $85.75 / $156.00	Professional	50	$18.78	$85.75	$156.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $18.38 / $32.01 / $43.98	Professional	52	$18.38	$32.01	$43.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.50 / $31.71 / $65.65	Professional	TC	$27.50	$31.71	$65.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.64 / $32.11 / $92.30	Professional		$31.64	$32.11	$92.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.09 / $10.11 / $19.88	Professional	26	$8.09	$10.11	$19.88
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $138.44 / $138.44 / $138.44	Professional	50	$138.44	$138.44	$138.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.01 / $30.01 / $30.01	Professional	TC	$30.01	$30.01	$30.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.00 / $63.00 / $63.00	Professional		$63.00	$63.00	$63.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.57 / $54.46 / $81.31	Professional		$33.57	$54.46	$81.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $16.63 / $23.09	Professional	26	$9.44	$16.63	$23.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.98 / $39.19 / $58.22	Professional	TC	$23.98	$39.19	$58.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.23 / $32.34 / $36.11	Professional		$9.23	$32.34	$36.11
United Facility/Professional Professional Modifier Low / Median / High Price $32.61 / $46.68 / $75.42	Professional		$32.61	$46.68	$75.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.21 / $13.09 / $24.55	Professional	26	$9.21	$13.09	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.46 / $34.07 / $59.11	Professional	TC	$22.46	$34.07	$59.11