Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.26 / $83.00 / $102.92	Facility	26	$68.26	$83.00	$102.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.08 / $275.00 / $691.05	Professional		$153.08	$275.00	$691.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.53 / $63.99 / $252.20	Professional	26	$46.53	$63.99	$252.20
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $67.23 / $137.50 / $137.50	Professional	52	$67.23	$137.50	$137.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $80.86 / $192.00 / $291.63	Professional	TC	$80.86	$192.00	$291.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.56 / $131.63 / $131.63	Professional		$100.56	$131.63	$131.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.22 / $51.35 / $85.51	Professional	26	$38.22	$51.35	$85.51
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $80.29 / $104.57 / $104.57	Professional	TC	$80.29	$104.57	$104.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.46 / $340.00 / $520.98	Professional		$122.46	$340.00	$520.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.77 / $127.00 / $174.32	Professional	26	$47.77	$127.00	$174.32
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $74.69 / $213.00 / $374.52	Professional	TC	$74.69	$213.00	$374.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.94 / $262.68 / $455.89	Professional		$157.94	$262.68	$455.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.00 / $73.05 / $131.91	Professional	26	$53.00	$73.05	$131.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.04 / $205.76 / $346.04	Professional	TC	$97.04	$205.76	$346.04
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $83.78 / $112.00 / $171.99	Facility	26	$83.78	$112.00	$171.99
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $88.83 / $494.81	Professional		$88.83	$88.83	$494.81
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $188.86 / $188.86 / $188.86	Professional	26	$188.86	$188.86	$188.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $118.03 / $176.54	Professional		$44.14	$118.03	$176.54
United Facility/Professional Professional Modifier Low / Median / High Price $149.56 / $233.07 / $433.98	Professional		$149.56	$233.07	$433.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.05 / $71.03 / $118.39	Professional	26	$50.05	$71.03	$118.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.30 / $153.99 / $325.50	Professional	TC	$93.30	$153.99	$325.50