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 / $90.99	Facility	26	$83.00	$83.00	$90.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $160.88 / $275.00 / $595.40	Professional		$160.88	$275.00	$595.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $71.89 / $151.80	Professional	26	$55.00	$71.89	$151.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.67 / $192.00 / $291.63	Professional	TC	$102.67	$192.00	$291.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $146.29 / $157.26 / $157.26	Professional		$146.29	$157.26	$157.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.07 / $56.87 / $101.80	Professional	26	$46.07	$56.87	$101.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $125.19 / $125.19 / $125.19	Professional	TC	$125.19	$125.19	$125.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.29 / $297.00 / $518.40	Professional		$146.29	$297.00	$518.40
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.87 / $102.00 / $157.49	Professional	26	$56.87	$102.00	$157.49
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.42 / $195.00 / $346.85	Professional	TC	$89.42	$195.00	$346.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.22 / $281.14 / $505.43	Professional		$216.22	$281.14	$505.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.71 / $84.50 / $141.59	Professional	26	$58.71	$84.50	$141.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.91 / $212.95 / $374.59	Professional	TC	$134.91	$212.95	$374.59
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $92.09 / $107.00 / $187.65	Facility	26	$92.09	$107.00	$187.65
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $88.83 / $592.08	Professional		$88.83	$88.83	$592.08
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $224.66 / $224.66 / $224.66	Professional	26	$224.66	$224.66	$224.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $118.03 / $176.58	Professional		$44.14	$118.03	$176.58
United Facility/Professional Professional Modifier Low / Median / High Price $191.96 / $271.45 / $467.51	Professional		$191.96	$271.45	$467.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.99 / $78.66 / $130.55	Professional	26	$59.99	$78.66	$130.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.32 / $202.44 / $365.01	Professional	TC	$131.32	$202.44	$365.01