Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.90 / $83.00 / $97.79	Facility	26	$50.90	$83.00	$97.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.70 / $275.00 / $552.50	Professional		$119.70	$275.00	$552.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.40 / $56.35 / $231.40	Professional	26	$37.40	$56.35	$231.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.47 / $176.95 / $266.39	Professional	TC	$67.47	$176.95	$266.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.67 / $98.22 / $105.59	Professional		$80.67	$98.22	$105.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.11 / $40.54 / $67.50	Professional	26	$30.11	$40.54	$67.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $84.71 / $108.31 / $108.31	Professional	TC	$84.71	$108.31	$108.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.22 / $267.00 / $469.47	Professional		$98.22	$267.00	$469.47
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.71 / $76.00 / $126.27	Professional	26	$37.71	$76.00	$126.27
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.51 / $191.00 / $338.38	Professional	TC	$60.51	$191.00	$338.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.25 / $203.00 / $367.36	Professional		$116.25	$203.00	$367.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.13 / $57.00 / $104.40	Professional	26	$39.13	$57.00	$104.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.95 / $157.50 / $266.00	Professional	TC	$72.95	$157.50	$266.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $61.62 / $90.19 / $145.00	Facility	26	$61.62	$90.19	$145.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $88.83 / $393.54	Professional		$88.83	$88.83	$393.54
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $245.68 / $245.68 / $245.68	Professional	TC	$245.68	$245.68	$245.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $80.55 / $128.34	Professional		$44.14	$80.55	$128.34
United Facility/Professional Professional Modifier Low / Median / High Price $109.07 / $181.47 / $329.04	Professional		$109.07	$181.47	$329.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.29 / $51.48 / $87.03	Professional	26	$39.29	$51.48	$87.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.67 / $107.74 / $257.41	Professional	TC	$66.67	$107.74	$257.41