Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $131.83 / $165.96	Facility	26	$131.83	$131.83	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $501.19 / $1,737.80	Professional		$323.59	$501.19	$1,737.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $162.18 / $380.19	Professional	26	$102.33	$162.18	$380.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $338.84 / $758.58	Professional	TC	$218.78	$338.84	$758.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $239.88 / $323.59	Professional		$141.25	$239.88	$323.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $109.65 / $181.97	Professional	26	$83.18	$109.65	$181.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $190.55 / $346.74	Professional	TC	$158.49	$190.55	$346.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $588.84 / $1,047.13	Professional		$309.03	$588.84	$1,047.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $229.09 / $363.08	Professional	26	$107.15	$229.09	$363.08
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $316.23 / $758.58	Professional	TC	$204.17	$316.23	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $724.44 / $1,513.56	Professional		$371.54	$724.44	$1,513.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $151.36 / $251.19	Professional	26	$107.15	$151.36	$251.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $489.78 / $1,174.90	Professional	TC	$251.19	$489.78	$1,174.90
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Professional		$1,047.13	$1,047.13	$1,047.13
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Professional	26	$223.87	$223.87	$223.87
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 / $616.60 / $1,412.54	Professional		$346.74	$616.60	$1,412.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $134.90 / $234.42	Professional	26	$104.71	$134.90	$234.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $446.68 / $1,148.15	Professional	TC	$234.42	$446.68	$1,148.15