Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.45 / $83.00 / $102.92	Facility	26	$70.45	$83.00	$102.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.13 / $275.00 / $357.50	Professional		$149.13	$275.00	$357.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $62.14 / $115.01	Professional	26	$44.14	$62.14	$115.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $92.71 / $192.00 / $252.15	Professional	TC	$92.71	$192.00	$252.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $119.31 / $167.91 / $167.91	Professional		$119.31	$167.91	$167.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.02 / $46.72 / $78.83	Professional	26	$22.02	$46.72	$78.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $67.75 / $105.39 / $105.39	Professional	TC	$67.75	$105.39	$105.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.31 / $340.00 / $486.25	Professional		$119.31	$340.00	$486.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.04 / $127.00 / $174.26	Professional	26	$44.04	$127.00	$174.26
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $75.28 / $213.00 / $327.50	Professional	TC	$75.28	$213.00	$327.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.49 / $262.68 / $467.48	Professional		$166.49	$262.68	$467.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.24 / $67.01 / $121.00	Professional	26	$51.24	$67.01	$121.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $110.02 / $201.98 / $347.94	Professional	TC	$110.02	$201.98	$347.94
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $83.78 / $97.00 / $171.99	Facility	26	$83.78	$97.00	$171.99
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $88.83 / $483.44	Professional		$88.83	$88.83	$483.44
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $175.09 / $175.09 / $175.09	Professional	26	$175.09	$175.09	$175.09
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 $148.99 / $227.49 / $422.60	Professional		$148.99	$227.49	$422.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.94 / $64.31 / $107.71	Professional	26	$47.94	$64.31	$107.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.62 / $157.38 / $325.50	Professional	TC	$100.62	$157.38	$325.50