Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.00 / $102.92 / $256.52	Facility	26	$83.00	$102.92	$256.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.54 / $392.89 / $688.48	Professional		$255.54	$392.89	$688.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.83 / $91.57 / $278.63	Professional	26	$76.83	$91.57	$278.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.13 / $264.16 / $502.73	Professional	TC	$169.13	$264.16	$502.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.80 / $212.61 / $212.61	Professional		$130.80	$212.61	$212.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.86 / $86.76 / $144.47	Professional	26	$63.86	$86.76	$144.47
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $162.63 / $162.63 / $227.68	Professional	TC	$162.63	$162.63	$227.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $243.34 / $315.00 / $532.55	Professional		$243.34	$315.00	$532.55
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $80.00 / $88.25 / $146.00	Professional	26	$80.00	$88.25	$146.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.63 / $220.00 / $391.32	Professional	TC	$162.63	$220.00	$391.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.94 / $490.28 / $841.10	Professional		$302.94	$490.28	$841.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.39 / $117.61 / $217.38	Professional	26	$88.39	$117.61	$217.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $210.00 / $397.53 / $657.47	Professional	TC	$210.00	$397.53	$657.47
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $137.58 / $160.00 / $272.39	Facility	26	$137.58	$160.00	$272.39
Medcost Facility/Professional Professional Modifier Low / Median / High Price $145.72 / $145.72 / $940.39	Professional		$145.72	$145.72	$940.39
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $622.40 / $622.40 / $622.40	Professional	TC	$622.40	$622.40	$622.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $178.71 / $320.65	Professional		$96.53	$178.71	$320.65
United Facility/Professional Professional Modifier Low / Median / High Price $284.20 / $433.23 / $795.42	Professional		$284.20	$433.23	$795.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.63 / $112.05 / $185.95	Professional	26	$83.63	$112.05	$185.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.56 / $326.19 / $655.34	Professional	TC	$194.56	$326.19	$655.34