Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $128.13 / $128.13 / $128.13	Facility	TC	$128.13	$128.13	$128.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.70 / $143.60 / $254.00	Professional		$67.70	$143.60	$254.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.72 / $51.08 / $202.00	Professional	26	$21.72	$51.08	$202.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.98 / $94.92 / $105.29	Professional	TC	$45.98	$94.92	$105.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.44 / $51.44 / $51.44	Professional		$51.44	$51.44	$51.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.78 / $15.78 / $63.13	Professional	26	$15.78	$15.78	$63.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $35.65 / $35.65 / $35.65	Professional	TC	$35.65	$35.65	$35.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.43 / $86.43 / $86.43	Professional		$86.43	$86.43	$86.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.97 / $54.42 / $129.61	Professional		$32.97	$54.42	$129.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.85 / $30.93 / $55.03	Professional	26	$12.85	$30.93	$55.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.82 / $49.77 / $101.02	Professional	TC	$21.82	$49.77	$101.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $48.27 / $94.19 / $158.38	Professional		$48.27	$94.19	$158.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.97 / $28.44 / $55.23	Professional	26	$15.97	$28.44	$55.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.29 / $64.59 / $109.82	Professional	TC	$32.29	$64.59	$109.82