Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.45 / $104.45 / $207.03	Facility	26	$104.45	$104.45	$207.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $351.80 / $425.00 / $569.24	Professional		$351.80	$425.00	$569.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $127.25 / $175.47	Professional	26	$85.00	$127.25	$175.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $266.08 / $335.00 / $433.06	Professional	TC	$266.08	$335.00	$433.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.63 / $85.49 / $142.36	Professional	26	$63.63	$85.49	$142.36
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $330.18 / $330.18 / $330.18	Professional	TC	$330.18	$330.18	$330.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.95 / $612.00 / $1,183.98	Professional		$316.95	$612.00	$1,183.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.53 / $118.00 / $157.83	Professional	26	$79.53	$118.00	$157.83
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $235.84 / $494.00 / $878.69	Professional	TC	$235.84	$494.00	$878.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $419.05 / $876.87 / $1,492.64	Professional		$419.05	$876.87	$1,492.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.72 / $117.00 / $219.84	Professional	26	$82.72	$117.00	$219.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $321.44 / $671.85 / $1,320.92	Professional	TC	$321.44	$671.85	$1,320.92
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $128.31 / $151.00 / $266.31	Facility	26	$128.31	$151.00	$266.31
Medcost Facility/Professional Professional Modifier Low / Median / High Price $300.42 / $300.42 / $1,294.61	Professional		$300.42	$300.42	$1,294.61
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $315.45 / $315.45 / $315.45	Professional	26	$315.45	$315.45	$315.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $274.12 / $451.26	Professional		$96.53	$274.12	$451.26
United Facility/Professional Professional Modifier Low / Median / High Price $378.60 / $638.71 / $1,358.62	Professional		$378.60	$638.71	$1,358.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.29 / $107.89 / $184.46	Professional	26	$80.29	$107.89	$184.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $280.48 / $479.15 / $1,227.60	Professional	TC	$280.48	$479.15	$1,227.60