Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.25 / $53.25 / $53.25	Facility		$53.25	$53.25	$53.25
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $140.94 / $140.94 / $140.94	Facility	TC	$140.94	$140.94	$140.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.61 / $98.95 / $182.62	Professional		$76.61	$98.95	$182.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.81 / $60.22 / $66.80	Professional	26	$26.81	$60.22	$66.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.80 / $104.41 / $115.82	Professional	TC	$49.80	$104.41	$115.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.11 / $60.11 / $128.52	Professional		$60.11	$60.11	$128.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.47 / $19.47 / $77.90	Professional	26	$19.47	$19.47	$77.90
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $45.08 / $45.08 / $45.08	Professional	TC	$45.08	$45.08	$45.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.75 / $133.75 / $133.75	Professional		$133.75	$133.75	$133.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.79 / $85.63 / $173.41	Professional		$46.79	$85.63	$173.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $45.54 / $77.58	Professional	26	$16.22	$45.54	$77.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.06 / $54.11 / $98.48	Professional	TC	$30.06	$54.11	$98.48
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 $57.56 / $117.91 / $237.88	Professional		$57.56	$117.91	$237.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.09 / $36.81 / $96.98	Professional	26	$22.09	$36.81	$96.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.79 / $70.51 / $116.77	Professional	TC	$36.79	$70.51	$116.77