Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $132.77 / $132.77 / $170.53	Facility	26	$132.77	$132.77	$170.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $353.49 / $475.00 / $1,288.95	Professional		$353.49	$475.00	$1,288.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.29 / $140.00 / $402.43	Professional	26	$99.29	$140.00	$402.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $219.91 / $335.00 / $462.42	Professional	TC	$219.91	$335.00	$462.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $293.58 / $315.61 / $513.78	Professional		$293.58	$315.61	$513.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.62 / $109.67 / $182.62	Professional	26	$81.62	$109.67	$182.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $268.20 / $268.20 / $268.20	Professional	TC	$268.20	$268.20	$268.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.06 / $660.00 / $1,274.00	Professional		$295.06	$660.00	$1,274.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.02 / $265.00 / $391.26	Professional	26	$102.02	$265.00	$391.26
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $191.57 / $395.00 / $825.88	Professional	TC	$191.57	$395.00	$825.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $374.95 / $740.00 / $1,388.43	Professional		$374.95	$740.00	$1,388.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.61 / $156.97 / $278.00	Professional	26	$117.61	$156.97	$278.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $256.70 / $547.52 / $1,167.27	Professional	TC	$256.70	$547.52	$1,167.27
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $185.39 / $249.00 / $379.71	Facility	26	$185.39	$249.00	$379.71
Medcost Facility/Professional Professional Modifier Low / Median / High Price $300.42 / $300.42 / $1,209.28	Professional		$300.42	$300.42	$1,209.28
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $400.02 / $400.02 / $400.02	Professional	26	$400.02	$400.02	$400.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $210.04 / $363.04	Professional		$96.53	$210.04	$363.04
United Facility/Professional Professional Modifier Low / Median / High Price $351.09 / $552.54 / $1,312.67	Professional		$351.09	$552.54	$1,312.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.91 / $142.69 / $234.31	Professional	26	$107.91	$142.69	$234.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $236.84 / $398.45 / $1,122.57	Professional	TC	$236.84	$398.45	$1,122.57