Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.01 / $86.02 / $106.66	Facility	26	$86.01	$86.02	$106.66
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $48.03 / $48.03 / $124.61	Facility	53	$48.03	$48.03	$124.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $217.18 / $475.00 / $1,143.25	Professional		$217.18	$475.00	$1,143.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.37 / $106.66 / $528.64	Professional	26	$65.37	$106.66	$528.64
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $100.09 / $120.07 / $393.13	Professional	52	$100.09	$120.07	$393.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.09 / $335.00 / $434.22	Professional	TC	$154.09	$335.00	$434.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $180.49 / $194.03 / $315.86	Professional		$180.49	$194.03	$315.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.30 / $70.27 / $117.01	Professional	26	$52.30	$70.27	$117.01
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $115.11 / $161.15 / $207.20	Professional	TC	$115.11	$161.15	$207.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.39 / $460.00 / $722.91	Professional		$181.39	$460.00	$722.91
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.37 / $132.00 / $232.10	Professional	26	$65.37	$132.00	$232.10
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $115.11 / $328.00 / $490.13	Professional	TC	$115.11	$328.00	$490.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $227.40 / $485.71 / $844.15	Professional		$227.40	$485.71	$844.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.73 / $99.00 / $181.06	Professional	26	$67.73	$99.00	$181.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.32 / $326.95 / $632.00	Professional	TC	$151.32	$326.95	$632.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $106.00 / $128.01 / $260.00	Facility	26	$106.00	$128.01	$260.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $187.72 / $187.72 / $736.63	Professional		$187.72	$187.72	$736.63
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $477.19 / $477.19 / $477.19	Professional	TC	$477.19	$477.19	$477.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.54 / $130.32 / $212.63	Professional		$63.54	$130.32	$212.63
United Facility/Professional Professional Modifier Low / Median / High Price $213.22 / $340.68 / $757.52	Professional		$213.22	$340.68	$757.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.54 / $99.00 / $151.88	Professional	26	$68.54	$99.00	$151.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.21 / $220.25 / $649.74	Professional	TC	$140.21	$220.25	$649.74