Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.43 / $83.00 / $103.75	Facility	26	$76.43	$83.00	$103.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.40 / $171.00 / $275.00	Professional		$134.40	$171.00	$275.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.10 / $69.30 / $99.06	Professional	26	$46.10	$69.30	$99.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.64 / $119.70 / $220.00	Professional	TC	$87.64	$119.70	$220.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.98 / $136.05 / $136.05	Professional		$103.98	$136.05	$136.05
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 $84.70 / $110.31 / $110.31	Professional	TC	$84.70	$110.31	$110.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.56 / $187.00 / $276.64	Professional		$126.56	$187.00	$276.64
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.00 / $39.84 / $62.10	Professional	26	$26.00	$39.84	$62.10
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.79 / $161.00 / $217.17	Professional	TC	$78.79	$161.00	$217.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.97 / $188.19 / $324.94	Professional		$150.97	$188.19	$324.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.74 / $66.54 / $118.95	Professional	26	$53.74	$66.54	$118.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.16 / $116.79 / $205.99	Professional	TC	$95.16	$116.79	$205.99
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $75.20 / $75.54 / $122.56	Facility	26	$75.20	$75.54	$122.56
Medcost Facility/Professional Professional Modifier Low / Median / High Price $511.34 / $511.34 / $511.34	Professional		$511.34	$511.34	$511.34
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $322.52 / $322.52 / $322.52	Professional	TC	$322.52	$322.52	$322.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $118.26 / $176.58	Professional		$44.14	$118.26	$176.58
United Facility/Professional Professional Modifier Low / Median / High Price $137.94 / $189.68 / $303.66	Professional		$137.94	$189.68	$303.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.80 / $64.45 / $108.99	Professional	26	$49.80	$64.45	$108.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.88 / $124.28 / $194.67	Professional	TC	$89.88	$124.28	$194.67