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 / $383.93 / $615.49	Professional		$252.15	$383.93	$615.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.39 / $86.36 / $245.12	Professional	26	$73.39	$86.36	$245.12
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 $119.98 / $257.95 / $419.93	Professional		$119.98	$257.95	$419.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.31 / $83.13 / $138.41	Professional	26	$61.31	$83.13	$138.41
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $113.84 / $162.63 / $162.63	Professional	TC	$113.84	$162.63	$162.63
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 $295.47 / $504.43 / $948.77	Professional		$295.47	$504.43	$948.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.81 / $113.05 / $208.91	Professional	26	$80.81	$113.05	$208.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $206.38 / $397.00 / $692.44	Professional	TC	$206.38	$397.00	$692.44
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $125.93 / $146.00 / $256.95	Facility	26	$125.93	$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 $277.75 / $446.82 / $815.50	Professional		$277.75	$446.82	$815.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.55 / $107.66 / $178.67	Professional	26	$80.55	$107.66	$178.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $191.62 / $340.84 / $694.68	Professional	TC	$191.62	$340.84	$694.68