Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Facility		$53.70	$53.70	$53.70
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $141.25 / $141.25 / $141.25	Facility	TC	$141.25	$141.25	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $100.00 / $173.78	Professional		$70.79	$100.00	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $50.12 / $64.57	Professional	26	$25.12	$50.12	$64.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $66.07 / $114.82	Professional	TC	$45.71	$66.07	$114.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Professional		$61.66	$61.66	$61.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $19.50 / $100.00	Professional	26	$15.49	$19.50	$100.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $37.15 / $37.15	Professional	TC	$37.15	$37.15	$37.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Professional		$123.03	$123.03	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $85.11 / $173.78	Professional		$46.77	$85.11	$173.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $45.71 / $77.62	Professional	26	$16.22	$45.71	$77.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $53.70 / $100.00	Professional	TC	$30.20	$53.70	$100.00
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 $58.88 / $107.15 / $181.97	Professional		$58.88	$107.15	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $37.15 / $87.10	Professional	26	$21.38	$37.15	$87.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $70.79 / $117.49	Professional	TC	$36.31	$70.79	$117.49