Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.20 / $124.21 / $152.72	Facility	26	$124.20	$124.21	$152.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $348.45 / $475.00 / $1,263.59	Professional		$348.45	$475.00	$1,263.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $140.00 / $527.69	Professional	26	$85.00	$140.00	$527.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $246.81 / $335.00 / $456.99	Professional	TC	$246.81	$335.00	$456.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $310.06 / $310.06 / $333.31	Professional		$310.06	$310.06	$333.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.37 / $102.62 / $170.87	Professional	26	$77.37	$102.62	$170.87
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $300.45 / $300.45 / $300.45	Professional	TC	$300.45	$300.45	$300.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $311.61 / $660.00 / $1,173.96	Professional		$311.61	$660.00	$1,173.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.46 / $107.34 / $161.03	Professional	26	$95.46	$107.34	$161.03
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $214.61 / $557.00 / $979.37	Professional	TC	$214.61	$557.00	$979.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.02 / $787.27 / $1,449.59	Professional		$398.02	$787.27	$1,449.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.23 / $137.25 / $261.44	Professional	26	$98.23	$137.25	$261.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $288.02 / $613.90 / $1,199.68	Professional	TC	$288.02	$613.90	$1,199.68
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $154.59 / $179.00 / $314.38	Facility	26	$154.59	$179.00	$314.38
Medcost Facility/Professional Professional Modifier Low / Median / High Price $300.42 / $300.42 / $1,282.30	Professional		$300.42	$300.42	$1,282.30
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $374.04 / $374.04 / $374.04	Professional	26	$374.04	$374.04	$374.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $243.45 / $407.48	Professional		$96.53	$243.45	$407.48
United Facility/Professional Professional Modifier Low / Median / High Price $372.15 / $616.60 / $1,286.31	Professional		$372.15	$616.60	$1,286.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.98 / $127.88 / $218.82	Professional	26	$97.98	$127.88	$218.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $269.85 / $443.15 / $1,145.83	Professional	TC	$269.85	$443.15	$1,145.83