Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $30.90 / $43.65	Facility	26	$24.55	$30.90	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $63.10 / $169.82	Professional		$43.65	$63.10	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $48.98 / $104.71	Professional	26	$25.12	$48.98	$104.71
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.13 / $46.77 / $104.71	Professional	52	$14.13	$46.77	$104.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $26.92 / $60.26	Professional	TC	$19.05	$26.92	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $40.74 / $83.18	Professional		$33.88	$40.74	$83.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $26.92 / $44.67	Professional	26	$21.38	$26.92	$44.67
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $9.77 / $9.77 / $21.38	Professional	52	$9.77	$9.77	$21.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $17.38 / $30.20	Professional	TC	$14.79	$17.38	$30.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $54.95 / $75.86	Professional		$48.98	$54.95	$75.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $30.90 / $42.66	Professional	26	$26.92	$30.90	$42.66
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $25.12 / $36.31	Professional	TC	$21.38	$25.12	$36.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $63.10 / $104.71	Professional		$47.86	$63.10	$104.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $35.48 / $58.88	Professional	26	$26.92	$35.48	$58.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $29.51 / $46.77	Professional	TC	$21.38	$29.51	$46.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $63.10 / $104.71	Professional		$51.29	$63.10	$104.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $35.48 / $57.54	Professional	26	$28.18	$35.48	$57.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $28.18 / $47.86	Professional	TC	$22.91	$28.18	$47.86