Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $131.83 / $707.95	Facility	26	$117.49	$131.83	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $724.44 / $1,000.00	Professional		$575.44	$724.44	$1,000.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $154.88 / $371.54	Professional	26	$114.82	$154.88	$371.54
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $199.53 / $199.53 / $199.53	Professional	52	$199.53	$199.53	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $562.34 / $794.33	Professional	TC	$467.74	$562.34	$794.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $616.60 / $1,412.54	Professional		$537.03	$616.60	$1,412.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $138.04 / $177.83	Professional	26	$112.20	$138.04	$177.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $512.86 / $575.44	Professional	TC	$478.63	$512.86	$575.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Professional		$1,258.93	$1,258.93	$1,258.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $977.24 / $1,288.25	Professional		$645.65	$977.24	$1,288.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $208.93 / $295.12	Professional	26	$134.90	$208.93	$295.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $501.19 / $758.58 / $1,000.00	Professional	TC	$501.19	$758.58	$1,000.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $100.00	Professional		$32.36	$33.11	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $812.83 / $1,202.26	Professional		$562.34	$812.83	$1,202.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $162.18 / $281.84	Professional	26	$112.20	$162.18	$281.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $630.96 / $933.25	Professional	TC	$446.68	$630.96	$933.25