Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $131.83 / $165.96	Facility	26	$131.83	$131.83	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $537.03 / $1,778.28	Professional		$323.59	$537.03	$1,778.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $186.21 / $602.56	Professional	26	$102.33	$186.21	$602.56
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $138.04 / $138.04 / $239.88	Professional	52	$138.04	$138.04	$239.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $338.84 / $831.76	Professional	TC	$218.78	$338.84	$831.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $316.23 / $549.54	Professional		$239.88	$316.23	$549.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $100.00 / $173.78	Professional	26	$81.28	$100.00	$173.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $213.80 / $354.81	Professional	TC	$158.49	$213.80	$354.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $588.84 / $1,047.13	Professional		$309.03	$588.84	$1,047.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $190.55 / $288.40	Professional	26	$107.15	$190.55	$288.40
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $407.38 / $758.58	Professional	TC	$204.17	$407.38	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $724.44 / $1,513.56	Professional		$363.08	$724.44	$1,513.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $151.36 / $275.42	Professional	26	$107.15	$151.36	$275.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $501.19 / $1,174.90	Professional	TC	$245.47	$501.19	$1,174.90
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,071.52	Professional		$1,071.52	$1,071.52	$1,071.52
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Professional	26	$223.87	$223.87	$223.87
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 $338.84 / $602.56 / $1,445.44	Professional		$338.84	$602.56	$1,445.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $131.83 / $229.09	Professional	26	$104.71	$131.83	$229.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $446.68 / $1,148.15	Professional	TC	$234.42	$446.68	$1,148.15