Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.92 / $110.50 / $164.18	Facility	26	$101.92	$110.50	$164.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $187.72 / $475.00 / $550.00	Professional		$187.72	$475.00	$550.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.56 / $140.00 / $164.18	Professional	26	$81.56	$140.00	$164.18
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $166.02 / $212.27 / $248.61	Professional	52	$166.02	$212.27	$248.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $224.16 / $333.04 / $368.50	Professional	TC	$224.16	$333.04	$368.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $143.09 / $176.81 / $406.66	Professional		$143.09	$176.81	$406.66
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 $609.99 / $609.99 / $609.99	Professional	50	$609.99	$609.99	$609.99
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $98.96 / $98.96 / $98.96	Professional	TC	$98.96	$98.96	$98.96
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 $171.03 / $378.94 / $842.54	Professional		$171.03	$378.94	$842.54
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 $116.29 / $267.29 / $710.97	Professional	TC	$116.29	$267.29	$710.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $159.13	Professional		$32.34	$32.34	$159.13
United Facility/Professional Professional Modifier Low / Median / High Price $205.00 / $287.89 / $869.46	Professional		$205.00	$287.89	$869.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.29 / $76.98 / $135.47	Professional	26	$54.29	$76.98	$135.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $139.40 / $206.50 / $765.98	Professional	TC	$139.40	$206.50	$765.98