Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.77 / $49.78 / $105.00	Facility	26	$24.77	$49.78	$105.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.45 / $119.52 / $182.96	Professional		$86.45	$119.52	$182.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.87 / $28.83 / $49.78	Professional	26	$22.87	$28.83	$49.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.27 / $88.40 / $133.18	Professional	TC	$66.27	$88.40	$133.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.90 / $92.85 / $207.25	Professional		$82.90	$92.85	$207.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.52 / $25.31 / $56.50	Professional	26	$21.52	$25.31	$56.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $157.00 / $157.00 / $157.00	Professional		$157.00	$157.00	$157.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.16 / $138.63 / $213.30	Professional		$91.16	$138.63	$213.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.58 / $37.60 / $57.65	Professional	26	$25.58	$37.60	$57.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.51 / $101.25 / $158.91	Professional	TC	$69.51	$101.25	$158.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $55.94	Professional		$32.34	$32.34	$55.94
United Facility/Professional Professional Modifier Low / Median / High Price $88.58 / $118.60 / $262.42	Professional		$88.58	$118.60	$262.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.48 / $30.90 / $74.65	Professional	26	$22.48	$30.90	$74.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.52 / $86.22 / $189.23	Professional	TC	$63.52	$86.22	$189.23