Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $132.77 / $132.77 / $164.63	Facility	26	$132.77	$132.77	$164.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $361.14 / $475.00 / $1,652.40	Professional		$361.14	$475.00	$1,652.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.73 / $143.38 / $656.50	Professional	26	$101.73	$143.38	$656.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $139.31 / $195.49 / $212.50	Professional	52	$139.31	$195.49	$212.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $237.41 / $335.00 / $603.60	Professional	TC	$237.41	$335.00	$603.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $240.66 / $314.66 / $336.62	Professional		$240.66	$314.66	$336.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.38 / $109.36 / $182.10	Professional	26	$81.38	$109.36	$182.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $190.98 / $205.30 / $267.37	Professional	TC	$190.98	$205.30	$267.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $294.17 / $660.00 / $1,225.00	Professional		$294.17	$660.00	$1,225.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $101.73 / $210.00 / $360.00	Professional	26	$101.73	$210.00	$360.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.98 / $450.00 / $893.76	Professional	TC	$190.98	$450.00	$893.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $372.46 / $740.00 / $1,384.70	Professional		$372.46	$740.00	$1,384.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.20 / $154.75 / $279.45	Professional	26	$108.20	$154.75	$279.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $254.27 / $543.47 / $1,171.16	Professional	TC	$254.27	$543.47	$1,171.16
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $168.65 / $250.02 / $361.00	Facility	26	$168.65	$250.02	$361.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $300.42 / $300.42 / $1,201.92	Professional		$300.42	$300.42	$1,201.92
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $400.02 / $400.02 / $400.02	Professional	26	$400.02	$400.02	$400.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $210.04 / $363.04	Professional		$96.53	$210.04	$363.04
United Facility/Professional Professional Modifier Low / Median / High Price $342.53 / $555.70 / $1,287.04	Professional		$342.53	$555.70	$1,287.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.26 / $141.19 / $231.36	Professional	26	$107.26	$141.19	$231.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $236.39 / $371.02 / $1,117.59	Professional	TC	$236.39	$371.02	$1,117.59