Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $158.49 / $257.04	Facility	26	$125.89	$158.49	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $758.58 / $1,318.26	Professional		$575.44	$758.58	$1,318.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $169.82 / $537.03	Professional	26	$114.82	$169.82	$537.03
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $181.97 / $239.88 / $616.60	Professional	52	$181.97	$239.88	$616.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $602.56 / $1,023.29	Professional	TC	$457.09	$602.56	$1,023.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $616.60 / $870.96	Professional		$549.54	$616.60	$870.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $138.04 / $181.97	Professional	26	$107.15	$138.04	$181.97
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $141.25 / $141.25 / $141.25	Professional	52	$141.25	$141.25	$141.25
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $323.59 / $512.86	Professional	TC	$323.59	$323.59	$512.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $707.95 / $1,047.13	Professional		$575.44	$707.95	$1,047.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $169.82 / $363.08	Professional	26	$120.23	$169.82	$363.08
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $549.54 / $741.31	Professional	TC	$302.00	$549.54	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $891.25 / $1,288.25	Professional		$660.69	$891.25	$1,288.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $204.17 / $281.84	Professional	26	$138.04	$204.17	$281.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $524.81 / $691.83 / $1,023.29	Professional	TC	$524.81	$691.83	$1,023.29
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 $588.84 / $741.31 / $1,122.02	Professional		$588.84	$741.31	$1,122.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $162.18 / $251.19	Professional	26	$112.20	$162.18	$251.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $588.84 / $912.01	Professional	TC	$446.68	$588.84	$912.01