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 / $174.89	Facility	26	$132.77	$132.77	$174.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $328.93 / $475.00 / $1,108.63	Professional		$328.93	$475.00	$1,108.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.95 / $140.00 / $377.10	Professional	26	$99.95	$140.00	$377.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $220.23 / $335.00 / $462.42	Professional	TC	$220.23	$335.00	$462.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $294.18 / $316.24 / $514.82	Professional		$294.18	$316.24	$514.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $82.70 / $109.67 / $182.62	Professional	26	$82.70	$109.67	$182.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $269.02 / $269.02 / $269.02	Professional	TC	$269.02	$269.02	$269.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.64 / $660.00 / $1,250.00	Professional		$295.64	$660.00	$1,250.00
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 $192.16 / $395.00 / $825.88	Professional	TC	$192.16	$395.00	$825.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $370.68 / $726.27 / $1,387.96	Professional		$370.68	$726.27	$1,387.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.16 / $154.75 / $272.72	Professional	26	$117.16	$154.75	$272.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $251.66 / $549.14 / $1,148.31	Professional	TC	$251.66	$549.14	$1,148.31
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $183.65 / $215.00 / $380.70	Facility	26	$183.65	$215.00	$380.70
Medcost Facility/Professional Professional Modifier Low / Median / High Price $300.42 / $300.42 / $1,210.46	Professional		$300.42	$300.42	$1,210.46
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 $345.80 / $588.20 / $1,368.10	Professional		$345.80	$588.20	$1,368.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $111.43 / $147.36 / $234.31	Professional	26	$111.43	$147.36	$234.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.68 / $377.43 / $1,072.40	Professional	TC	$239.68	$377.43	$1,072.40