Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $89.13 / $109.65	Facility	26	$85.11	$89.13	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $426.58 / $1,122.02	Professional		$194.98	$426.58	$1,122.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $125.89 / $263.03	Professional	26	$64.57	$125.89	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $229.09 / $478.63	Professional	TC	$123.03	$229.09	$478.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $165.96 / $199.53	Professional		$134.90	$165.96	$199.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $69.18 / $117.49	Professional	26	$52.48	$69.18	$117.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $123.03 / $199.53	Professional	TC	$91.20	$123.03	$199.53
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 / $162.18 / $245.47	Professional	26	$69.18	$162.18	$245.47
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $251.19 / $426.58	Professional	TC	$117.49	$251.19	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $478.63 / $912.01	Professional		$218.78	$478.63	$912.01
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 / $676.08	Professional	TC	$141.25	$302.00	$676.08
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 / $389.05 / $812.83	Professional		$204.17	$389.05	$812.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $87.10 / $147.91	Professional	26	$69.18	$87.10	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $257.04 / $676.08	Professional	TC	$131.83	$257.04	$676.08