Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $85.11 / $107.15	Facility	26	$85.11	$85.11	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $398.11 / $1,174.90	Professional		$199.53	$398.11	$1,174.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $102.33 / $354.81	Professional	26	$64.57	$102.33	$354.81
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $109.65 / $208.93 / $398.11	Professional	52	$109.65	$208.93	$398.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $234.42 / $457.09	Professional	TC	$128.82	$234.42	$457.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $181.97 / $316.23	Professional		$147.91	$181.97	$316.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $66.07 / $114.82	Professional	26	$52.48	$66.07	$114.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $107.15 / $123.03	Professional	TC	$95.50	$107.15	$123.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $416.87 / $691.83	Professional		$190.55	$416.87	$691.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $120.23 / $181.97	Professional	26	$69.18	$120.23	$181.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $263.03 / $467.74	Professional	TC	$123.03	$263.03	$467.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $467.74 / $891.25	Professional		$223.87	$467.74	$891.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $95.50 / $165.96	Professional	26	$67.61	$95.50	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $309.03 / $691.83	Professional	TC	$147.91	$309.03	$691.83
Medcost Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Professional		$812.83	$812.83	$812.83
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $138.04 / $138.04	Professional	26	$138.04	$138.04	$138.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $407.38 / $831.76	Professional		$208.93	$407.38	$831.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $83.18 / $147.91	Professional	26	$67.61	$83.18	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $269.15 / $707.95	Professional	TC	$138.04	$269.15	$707.95