Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.60 / $103.60 / $205.35	Facility	26	$103.60	$103.60	$205.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $276.35 / $430.84 / $598.50	Professional		$276.35	$430.84	$598.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.84 / $128.66 / $199.08	Professional	26	$80.84	$128.66	$199.08
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $125.00 / $165.71 / $212.50	Professional	52	$125.00	$165.71	$212.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $191.65 / $335.00 / $422.10	Professional	TC	$191.65	$335.00	$422.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.45 / $78.89 / $141.21	Professional	26	$39.45	$78.89	$141.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $248.01 / $660.00 / $1,042.00	Professional		$248.01	$660.00	$1,042.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $78.89 / $195.00 / $292.04	Professional	26	$78.89	$195.00	$292.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $169.13 / $465.00 / $769.50	Professional	TC	$169.13	$465.00	$769.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $315.75 / $579.62 / $1,017.81	Professional		$315.75	$579.62	$1,017.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.95 / $119.00 / $218.06	Professional	26	$81.95	$119.00	$218.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.70 / $453.22 / $757.00	Professional	TC	$223.70	$453.22	$757.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $127.26 / $149.00 / $264.14	Facility	26	$127.26	$149.00	$264.14
Medcost Facility/Professional Professional Modifier Low / Median / High Price $300.42 / $300.42 / $1,016.97	Professional		$300.42	$300.42	$1,016.97
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $311.70 / $311.70 / $311.70	Professional	26	$311.70	$311.70	$311.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $204.24 / $329.95	Professional		$96.53	$204.24	$329.95
United Facility/Professional Professional Modifier Low / Median / High Price $295.30 / $467.53 / $856.34	Professional		$295.30	$467.53	$856.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.09 / $109.57 / $181.83	Professional	26	$81.09	$109.57	$181.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $201.43 / $325.52 / $722.70	Professional	TC	$201.43	$325.52	$722.70