Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.00 / $83.00 / $103.75	Facility	26	$83.00	$83.00	$103.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.60 / $275.00 / $454.93	Professional		$176.60	$275.00	$454.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.86 / $73.15 / $110.30	Professional	26	$54.86	$73.15	$110.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $118.49 / $220.00 / $367.96	Professional	TC	$118.49	$220.00	$367.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.90 / $130.90 / $159.26	Professional		$130.90	$130.90	$159.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.56 / $60.47 / $100.69	Professional	26	$45.56	$60.47	$100.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $103.01 / $103.01 / $103.01	Professional	TC	$103.01	$103.01	$103.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $159.26 / $399.00 / $687.51	Professional		$159.26	$399.00	$687.51
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.25 / $140.00 / $189.42	Professional	26	$56.25	$140.00	$189.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $103.01 / $259.00 / $455.40	Professional	TC	$103.01	$259.00	$455.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.13 / $313.48 / $557.11	Professional		$192.13	$313.48	$557.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.33 / $84.00 / $155.19	Professional	26	$58.33	$84.00	$155.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $127.38 / $246.13 / $403.15	Professional	TC	$127.38	$246.13	$403.15
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $91.56 / $123.00 / $213.00	Facility	26	$91.56	$123.00	$213.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $145.72 / $145.72 / $649.89	Professional		$145.72	$145.72	$649.89
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $223.41 / $223.41 / $223.41	Professional	26	$223.41	$223.41	$223.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $127.90 / $207.66	Professional		$44.14	$127.90	$207.66
United Facility/Professional Professional Modifier Low / Median / High Price $180.15 / $267.37 / $523.45	Professional		$180.15	$267.37	$523.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.46 / $77.01 / $129.80	Professional	26	$58.46	$77.01	$129.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $118.86 / $200.90 / $392.49	Professional	TC	$118.86	$200.90	$392.49