Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $36.31 / $91.20	Facility	26	$28.18	$36.31	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $181.97 / $575.44	Professional		$100.00	$181.97	$575.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $58.88 / $173.78	Professional	26	$28.18	$58.88	$173.78
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.18 / $67.61 / $263.03	Professional	52	$28.18	$67.61	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $91.20 / $204.17	Professional	TC	$70.79	$91.20	$204.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $112.20 / $194.98	Professional		$81.28	$112.20	$194.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $32.36 / $51.29	Professional	26	$24.55	$32.36	$51.29
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $52.48 / $52.48 / $52.48	Professional	52	$52.48	$52.48	$52.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $69.18 / $87.10	Professional	TC	$52.48	$69.18	$87.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $131.83 / $245.47	Professional		$114.82	$131.83	$245.47
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $72.44 / $107.15	Professional	26	$33.11	$72.44	$107.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $81.28 / $165.96	Professional	TC	$34.67	$81.28	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $138.04 / $245.47	Professional		$97.72	$138.04	$245.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $44.67 / $67.61	Professional	26	$31.62	$44.67	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $93.33 / $173.78	Professional	TC	$61.66	$93.33	$173.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $123.03 / $208.93	Professional		$97.72	$123.03	$208.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $35.48 / $63.10	Professional	26	$28.18	$35.48	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $87.10 / $147.91	Professional	TC	$64.57	$87.10	$147.91