Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $83.18 / $104.71	Facility	26	$52.48	$83.18	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $263.03 / $691.83	Professional		$128.82	$263.03	$691.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $72.44 / $269.15	Professional	26	$37.15	$72.44	$269.15
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $457.09 / $1,174.90 / $1,174.90	Professional	52	$457.09	$1,174.90	$1,174.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $173.78 / $316.23	Professional	TC	$85.11	$173.78	$316.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $125.89 / $218.78	Professional		$95.50	$125.89	$218.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $38.90 / $64.57	Professional	26	$30.90	$38.90	$64.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $79.43 / $114.82	Professional	TC	$40.74	$79.43	$114.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $257.04 / $426.58	Professional		$125.89	$257.04	$426.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $91.20 / $141.25	Professional	26	$39.81	$91.20	$141.25
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $165.96 / $281.84	Professional	TC	$85.11	$165.96	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $245.47 / $457.09	Professional		$138.04	$245.47	$457.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $64.57 / $109.65	Professional	26	$41.69	$64.57	$109.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $173.78 / $309.03	Professional	TC	$93.33	$173.78	$309.03
Medcost Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Professional		$426.58	$426.58	$426.58
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $107.15 / $107.15	Professional	26	$107.15	$107.15	$107.15
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 $131.83 / $223.87 / $407.38	Professional		$131.83	$223.87	$407.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $56.23 / $104.71	Professional	26	$41.69	$56.23	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $158.49 / $316.23	Professional	TC	$89.13	$158.49	$316.23