Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $85.11 / $109.65	Facility	26	$85.11	$85.11	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $436.52 / $1,122.02	Professional		$194.98	$436.52	$1,122.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $120.23 / $323.59	Professional	26	$66.07	$120.23	$323.59
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $134.90 / $173.78 / $870.96	Professional	52	$134.90	$173.78	$870.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $223.87 / $501.19	Professional	TC	$112.20	$223.87	$501.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $186.21 / $331.13	Professional		$134.90	$186.21	$331.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $66.07 / $117.49	Professional	26	$52.48	$66.07	$117.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $125.89 / $204.17	Professional	TC	$89.13	$125.89	$204.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $416.87 / $691.83	Professional		$186.21	$416.87	$691.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $131.83 / $199.53	Professional	26	$69.18	$131.83	$199.53
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $281.84 / $457.09	Professional	TC	$117.49	$281.84	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $457.09 / $831.76	Professional		$218.78	$457.09	$831.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $97.72 / $165.96	Professional	26	$72.44	$97.72	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $302.00 / $630.96	Professional	TC	$141.25	$302.00	$630.96
Medcost Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Professional		$724.44	$724.44	$724.44
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $151.36 / $151.36	Professional	26	$151.36	$151.36	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $380.19 / $794.33	Professional		$204.17	$380.19	$794.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $87.10 / $151.36	Professional	26	$69.18	$87.10	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $257.04 / $645.65	Professional	TC	$131.83	$257.04	$645.65