Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.35 / $45.35 / $693.60	Facility	26	$45.35	$45.35	$693.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.32 / $169.16 / $383.45	Professional		$87.32	$169.16	$383.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.93 / $59.07 / $107.59	Professional	26	$39.93	$59.07	$107.59
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $37.74 / $46.53 / $92.72	Professional	52	$37.74	$46.53	$92.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.89 / $96.46 / $162.43	Professional	TC	$42.89	$96.46	$162.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.52 / $156.66 / $156.66	Professional		$87.52	$156.66	$156.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.87 / $72.70 / $73.94	Professional	26	$56.87	$72.70	$73.94
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $83.93 / $83.93 / $83.93	Professional	TC	$83.93	$83.93	$83.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.52 / $163.00 / $286.60	Professional		$87.52	$163.00	$286.60
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.61 / $57.00 / $100.22	Professional	26	$40.61	$57.00	$100.22
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.89 / $106.00 / $180.97	Professional	TC	$46.89	$106.00	$180.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.72 / $200.10 / $298.64	Professional		$119.72	$200.10	$298.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.15 / $82.53 / $118.20	Professional	26	$52.15	$82.53	$118.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.07 / $114.69 / $173.02	Professional	TC	$63.07	$114.69	$173.02
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $66.76 / $97.00 / $115.06	Facility	26	$66.76	$97.00	$115.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.41 / $86.86 / $137.79	Professional		$45.41	$86.86	$137.79
United Facility/Professional Professional Modifier Low / Median / High Price $109.57 / $166.10 / $269.89	Professional		$109.57	$166.10	$269.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.73 / $60.04 / $104.63	Professional	26	$43.73	$60.04	$104.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.38 / $96.09 / $156.44	Professional	TC	$63.38	$96.09	$156.44