Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.80 / $83.00 / $98.55	Facility	26	$60.80	$83.00	$98.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.63 / $275.00 / $646.90	Professional		$144.63	$275.00	$646.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.50 / $61.26 / $297.00	Professional	26	$40.50	$61.26	$297.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $64.55 / $137.50 / $137.50	Professional	52	$64.55	$137.50	$137.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.60 / $192.00 / $291.63	Professional	TC	$88.60	$192.00	$291.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.57 / $99.80 / $126.22	Professional		$96.57	$99.80	$126.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.00 / $40.85 / $68.02	Professional	26	$19.00	$40.85	$68.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $67.50 / $111.17 / $111.17	Professional	TC	$67.50	$111.17	$111.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.41 / $284.00 / $455.87	Professional		$117.41	$284.00	$455.87
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.00 / $101.00 / $149.32	Professional	26	$38.00	$101.00	$149.32
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.41 / $183.00 / $320.35	Professional	TC	$79.41	$183.00	$320.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.72 / $246.24 / $425.17	Professional		$139.72	$246.24	$425.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.25 / $64.93 / $109.82	Professional	26	$44.25	$64.93	$109.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $96.08 / $188.68 / $306.83	Professional	TC	$96.08	$188.68	$306.83
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $73.80 / $95.00 / $155.27	Facility	26	$73.80	$95.00	$155.27
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $88.83 / $475.09	Professional		$88.83	$88.83	$475.09
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $149.04 / $149.04 / $149.04	Professional	26	$149.04	$149.04	$149.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $118.03 / $176.54	Professional		$44.14	$118.03	$176.54
United Facility/Professional Professional Modifier Low / Median / High Price $130.80 / $213.66 / $389.95	Professional		$130.80	$213.66	$389.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.28 / $57.24 / $96.15	Professional	26	$42.28	$57.24	$96.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.64 / $149.18 / $288.93	Professional	TC	$89.64	$149.18	$288.93