Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $38.90 / $54.95	Facility	26	$30.90	$38.90	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $165.96 / $446.68	Professional		$104.71	$165.96	$446.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $45.71 / $131.83	Professional	26	$30.90	$45.71	$131.83
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $20.42 / $66.07 / $213.80	Professional	52	$20.42	$66.07	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $97.72 / $204.17	Professional	TC	$75.86	$97.72	$204.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $97.72 / $204.17	Professional		$79.43	$97.72	$204.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $33.88 / $53.70	Professional	26	$26.92	$33.88	$53.70
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $23.99 / $23.99 / $51.29	Professional	52	$23.99	$23.99	$51.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $69.18 / $114.82	Professional	TC	$57.54	$69.18	$114.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $123.03 / $181.97	Professional		$77.62	$123.03	$181.97
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $36.31 / $51.29	Professional	26	$25.70	$36.31	$51.29
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $87.10 / $123.03	Professional	TC	$51.29	$87.10	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $154.88 / $257.04	Professional		$120.23	$154.88	$257.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $44.67 / $74.13	Professional	26	$34.67	$44.67	$74.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $114.82 / $181.97	Professional	TC	$89.13	$114.82	$181.97
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 $125.89 / $154.88 / $257.04	Professional		$125.89	$154.88	$257.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $45.71 / $72.44	Professional	26	$34.67	$45.71	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $109.65 / $186.21	Professional	TC	$89.13	$109.65	$186.21