Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $109.65 / $165.96	Facility	26	$102.33	$109.65	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $331.13 / $691.83	Professional		$63.10	$331.13	$691.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $109.65 / $234.42	Professional	26	$60.26	$109.65	$234.42
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $309.03 / $309.03 / $758.58	Professional	50	$309.03	$309.03	$758.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $251.19 / $501.19	Professional	TC	$141.25	$251.19	$501.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $181.97 / $316.23	Professional		$141.25	$181.97	$316.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $63.10 / $117.49	Professional	26	$47.86	$63.10	$117.49
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $630.96 / $630.96 / $630.96	Professional	50	$630.96	$630.96	$630.96
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $123.03 / $169.82	Professional	TC	$104.71	$123.03	$169.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Professional		$501.19	$501.19	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $398.11 / $851.14	Professional		$169.82	$398.11	$851.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $104.71 / $138.04	Professional	26	$48.98	$104.71	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $281.84 / $707.95	Professional	TC	$117.49	$281.84	$707.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $107.15	Professional		$32.36	$33.11	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $281.84 / $870.96	Professional		$194.98	$281.84	$870.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $74.13 / $134.90	Professional	26	$54.95	$74.13	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $194.98 / $724.44	Professional	TC	$134.90	$194.98	$724.44