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 / $102.92	Facility	26	$83.00	$83.00	$102.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $187.80 / $281.16 / $840.65	Professional		$187.80	$281.16	$840.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.34 / $83.00 / $468.12	Professional	26	$59.34	$83.00	$468.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $122.00 / $221.81 / $363.74	Professional	TC	$122.00	$221.81	$363.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.88 / $169.02 / $181.70	Professional		$138.88	$169.02	$181.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.79 / $65.56 / $109.17	Professional	26	$48.79	$65.56	$109.17
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $140.44 / $151.24 / $151.24	Professional	TC	$140.44	$151.24	$151.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.02 / $345.00 / $541.84	Professional		$169.02	$345.00	$541.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.99 / $126.00 / $188.75	Professional	26	$60.99	$126.00	$188.75
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $108.03 / $219.00 / $353.09	Professional	TC	$108.03	$219.00	$353.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $203.55 / $302.92 / $515.79	Professional		$203.55	$302.92	$515.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.51 / $91.09 / $158.00	Professional	26	$63.51	$91.09	$158.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $133.07 / $226.26 / $369.56	Professional	TC	$133.07	$226.26	$369.56
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $99.69 / $128.00 / $203.26	Facility	26	$99.69	$128.00	$203.26
Medcost Facility/Professional Professional Modifier Low / Median / High Price $145.72 / $145.72 / $691.10	Professional		$145.72	$145.72	$691.10
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $448.96 / $448.96 / $448.96	Professional	TC	$448.96	$448.96	$448.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.54 / $130.32 / $212.63	Professional		$63.54	$130.32	$212.63
United Facility/Professional Professional Modifier Low / Median / High Price $190.89 / $285.42 / $511.63	Professional		$190.89	$285.42	$511.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.67 / $83.16 / $141.44	Professional	26	$63.67	$83.16	$141.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $124.72 / $198.60 / $357.21	Professional	TC	$124.72	$198.60	$357.21