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 / $123.72	Facility	26	$83.00	$83.00	$123.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.15 / $385.88 / $675.73	Professional		$252.15	$385.88	$675.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.17 / $86.36 / $200.26	Professional	26	$74.17	$86.36	$200.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.13 / $249.60 / $461.86	Professional	TC	$169.13	$249.60	$461.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.96 / $257.95 / $419.93	Professional		$239.96	$257.95	$419.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.76 / $83.13 / $138.41	Professional	26	$61.76	$83.13	$138.41
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $162.63 / $162.63 / $227.68	Professional	TC	$162.63	$162.63	$227.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.96 / $311.95 / $545.07	Professional		$239.96	$311.95	$545.07
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.33 / $118.00 / $167.64	Professional	26	$77.33	$118.00	$167.64
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.63 / $201.60 / $343.96	Professional	TC	$162.63	$201.60	$343.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.18 / $486.00 / $879.14	Professional		$296.18	$486.00	$879.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.47 / $115.33 / $208.91	Professional	26	$80.47	$115.33	$208.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $207.09 / $386.83 / $692.44	Professional	TC	$207.09	$386.83	$692.44
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $125.67 / $146.00 / $256.95	Facility	26	$125.67	$146.00	$256.95
Medcost Facility/Professional Professional Modifier Low / Median / High Price $145.72 / $145.72 / $927.91	Professional		$145.72	$145.72	$927.91
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $622.40 / $622.40 / $622.40	Professional	TC	$622.40	$622.40	$622.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $178.71 / $320.65	Professional		$96.53	$178.71	$320.65
United Facility/Professional Professional Modifier Low / Median / High Price $278.07 / $449.38 / $811.85	Professional		$278.07	$449.38	$811.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.08 / $107.40 / $178.68	Professional	26	$78.08	$107.40	$178.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $191.94 / $328.22 / $691.49	Professional	TC	$191.94	$328.22	$691.49