Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.20 / $83.00 / $102.92	Facility	26	$82.20	$83.00	$102.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $282.66 / $653.78	Professional		$171.00	$282.66	$653.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.56 / $75.23 / $291.20	Professional	26	$50.56	$75.23	$291.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $113.94 / $220.18 / $376.02	Professional	TC	$113.94	$220.18	$376.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.54 / $125.86 / $164.55	Professional		$76.54	$125.86	$164.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.90 / $55.41 / $92.26	Professional	26	$40.90	$55.41	$92.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $71.06 / $71.06 / $142.13	Professional	TC	$71.06	$71.06	$142.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.07 / $397.00 / $698.05	Professional		$153.07	$397.00	$698.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.54 / $110.00 / $186.20	Professional	26	$51.54	$110.00	$186.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $101.53 / $287.00 / $504.63	Professional	TC	$101.53	$287.00	$504.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.10 / $313.20 / $551.17	Professional		$197.10	$313.20	$551.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.69 / $79.53 / $143.41	Professional	26	$56.69	$79.53	$143.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $132.66 / $246.13 / $432.30	Professional	TC	$132.66	$246.13	$432.30
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $89.49 / $120.00 / $208.00	Facility	26	$89.49	$120.00	$208.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $145.72 / $145.72 / $620.82	Professional		$145.72	$145.72	$620.82
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $202.58 / $202.58 / $202.58	Professional	26	$202.58	$202.58	$202.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $127.90 / $207.66	Professional		$44.14	$127.90	$207.66
United Facility/Professional Professional Modifier Low / Median / High Price $184.66 / $275.48 / $521.91	Professional		$184.66	$275.48	$521.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.35 / $76.66 / $127.56	Professional	26	$55.35	$76.66	$127.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.04 / $209.71 / $393.58	Professional	TC	$125.04	$209.71	$393.58