Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.57 / $131.11 / $163.88	Facility	26	$125.57	$131.11	$163.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $425.00 / $522.50 / $857.21	Professional		$425.00	$522.50	$857.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $131.11 / $199.08	Professional	26	$85.00	$131.11	$199.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $304.38 / $365.42 / $543.66	Professional	TC	$304.38	$365.42	$543.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $416.61 / $416.61 / $416.61	Professional		$416.61	$416.61	$416.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.43 / $107.99 / $179.82	Professional	26	$81.43	$107.99	$179.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.37 / $660.00 / $1,173.96	Professional		$426.37	$660.00	$1,173.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.46 / $168.75 / $292.16	Professional	26	$100.46	$168.75	$292.16
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $325.91 / $435.00 / $942.21	Professional	TC	$325.91	$435.00	$942.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $568.13 / $913.37 / $1,514.00	Professional		$568.13	$913.37	$1,514.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.75 / $145.47 / $275.97	Professional	26	$103.75	$145.47	$275.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $439.26 / $744.79 / $1,355.77	Professional	TC	$439.26	$744.79	$1,355.77
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $161.90 / $189.00 / $330.05	Facility	26	$161.90	$189.00	$330.05
Medcost Facility/Professional Professional Modifier Low / Median / High Price $300.42 / $300.42 / $1,678.04	Professional		$300.42	$300.42	$1,678.04
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $393.98 / $393.98 / $393.98	Professional	26	$393.98	$393.98	$393.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.10 / $360.50 / $588.39	Professional		$96.10	$360.50	$588.39
United Facility/Professional Professional Modifier Low / Median / High Price $526.04 / $730.96 / $1,504.50	Professional		$526.04	$730.96	$1,504.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.24 / $132.91 / $221.78	Professional	26	$102.24	$132.91	$221.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $411.72 / $655.44 / $1,308.32	Professional	TC	$411.72	$655.44	$1,308.32