Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $141.25 / $173.78	Facility	26	$131.83	$141.25	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $478.63 / $1,778.28	Professional		$331.13	$478.63	$1,778.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $181.97 / $549.54	Professional	26	$102.33	$181.97	$549.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $338.84 / $831.76	Professional	TC	$218.78	$338.84	$831.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $302.00 / $524.81	Professional		$251.19	$302.00	$524.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $107.15 / $181.97	Professional	26	$81.28	$107.15	$181.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $190.55 / $275.42	Professional	TC	$190.55	$190.55	$275.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $588.84 / $1,000.00	Professional		$309.03	$588.84	$1,000.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $239.88 / $363.08	Professional	26	$107.15	$239.88	$363.08
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $316.23 / $691.83	Professional	TC	$204.17	$316.23	$691.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $724.44 / $1,479.11	Professional		$371.54	$724.44	$1,479.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $151.36 / $257.04	Professional	26	$112.20	$151.36	$257.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $501.19 / $1,174.90	Professional	TC	$251.19	$501.19	$1,174.90
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Professional		$1,000.00	$1,000.00	$1,000.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $239.88 / $239.88 / $239.88	Professional	26	$239.88	$239.88	$239.88
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 $346.74 / $602.56 / $1,380.38	Professional		$346.74	$602.56	$1,380.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $134.90 / $234.42	Professional	26	$107.15	$134.90	$234.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $426.58 / $1,122.02	Professional	TC	$234.42	$426.58	$1,122.02