Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.01 / $86.02 / $107.52	Facility	26	$86.01	$86.02	$107.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.68 / $437.13 / $922.02	Professional		$195.68	$437.13	$922.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.72 / $111.86 / $445.98	Professional	26	$67.72	$111.86	$445.98
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $97.84 / $116.80 / $212.50	Professional	52	$97.84	$116.80	$212.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $124.85 / $281.41 / $441.00	Professional	TC	$124.85	$281.41	$441.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $143.91 / $175.17 / $188.31	Professional		$143.91	$175.17	$188.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.44 / $70.59 / $117.55	Professional	26	$52.44	$70.59	$117.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $117.71 / $153.30 / $166.60	Professional	TC	$117.71	$153.30	$166.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.05 / $460.00 / $716.39	Professional		$176.05	$460.00	$716.39
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.67 / $143.00 / $251.44	Professional	26	$65.67	$143.00	$251.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $109.50 / $317.00 / $472.63	Professional	TC	$109.50	$317.00	$472.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $221.74 / $468.09 / $793.47	Professional		$221.74	$468.09	$793.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.30 / $102.22 / $181.06	Professional	26	$73.30	$102.22	$181.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.69 / $313.07 / $632.00	Professional	TC	$145.69	$313.07	$632.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $114.32 / $155.00 / $275.00	Facility	26	$114.32	$155.00	$275.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $187.72 / $187.72 / $720.10	Professional		$187.72	$187.72	$720.10
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $260.64 / $260.64 / $260.64	Professional	26	$260.64	$260.64	$260.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.54 / $130.32 / $212.63	Professional		$63.54	$130.32	$212.63
United Facility/Professional Professional Modifier Low / Median / High Price $207.84 / $344.84 / $740.34	Professional		$207.84	$344.84	$740.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.62 / $91.88 / $151.88	Professional	26	$69.62	$91.88	$151.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $130.83 / $215.03 / $572.79	Professional	TC	$130.83	$215.03	$572.79