Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $54.95 / $54.95	Facility	26	$54.95	$54.95	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $208.93 / $389.05	Professional		$91.20	$208.93	$389.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $75.86 / $138.04	Professional	26	$34.67	$75.86	$138.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $74.13 / $162.18	Professional	TC	$52.48	$74.13	$162.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $89.13 / $151.36	Professional		$75.86	$89.13	$151.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $41.69 / $56.23	Professional	26	$30.90	$41.69	$56.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $75.86 / $97.72	Professional	TC	$57.54	$75.86	$97.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $107.15 / $128.82	Professional		$79.43	$107.15	$128.82
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $42.66 / $50.12	Professional	26	$30.90	$42.66	$50.12
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $66.07 / $77.62	Professional	TC	$47.86	$66.07	$77.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $45.71 / $45.71	Facility	26	$45.71	$45.71	$45.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $123.03 / $275.42	Professional		$85.11	$123.03	$275.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $53.70 / $112.20	Professional	26	$38.90	$53.70	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $85.11 / $186.21	Professional	TC	$53.70	$85.11	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $104.71 / $147.91	Professional		$77.62	$104.71	$147.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $41.69 / $58.88	Professional	26	$32.36	$41.69	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $63.10 / $89.13	Professional	TC	$46.77	$63.10	$89.13