Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.68 / $69.68 / $138.02	Facility	26	$69.68	$69.68	$138.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $222.36 / $400.00 / $494.18	Professional		$222.36	$400.00	$494.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.32 / $85.00 / $140.00	Professional	26	$57.32	$85.00	$140.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.75 / $306.97 / $348.53	Professional	TC	$162.75	$306.97	$348.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $193.11 / $193.11 / $193.11	Professional		$193.11	$193.11	$193.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.51 / $53.13 / $95.10	Professional	26	$42.51	$53.13	$95.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $144.32 / $144.32 / $144.32	Professional	TC	$144.32	$144.32	$144.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.44 / $325.00 / $616.09	Professional		$198.44	$325.00	$616.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.13 / $79.00 / $105.66	Professional	26	$53.13	$79.00	$105.66
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.32 / $246.00 / $437.57	Professional	TC	$144.32	$246.00	$437.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.27 / $514.02 / $839.05	Professional		$267.27	$514.02	$839.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.86 / $79.00 / $146.69	Professional	26	$54.86	$79.00	$146.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $196.63 / $408.30 / $730.53	Professional	TC	$196.63	$408.30	$730.53
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $85.62 / $100.00 / $177.30	Facility	26	$85.62	$100.00	$177.30
Medcost Facility/Professional Professional Modifier Low / Median / High Price $187.72 / $187.72 / $809.86	Professional		$187.72	$187.72	$809.86
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $210.94 / $210.94 / $210.94	Professional	26	$210.94	$210.94	$210.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $183.60 / $274.57	Professional		$44.14	$183.60	$274.57
United Facility/Professional Professional Modifier Low / Median / High Price $239.34 / $371.77 / $755.44	Professional		$239.34	$371.77	$755.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.24 / $74.05 / $123.20	Professional	26	$53.24	$74.05	$123.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $178.97 / $302.50 / $689.06	Professional	TC	$178.97	$302.50	$689.06