Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.00 / $83.00 / $83.00	Facility	26	$83.00	$83.00	$83.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.59 / $288.56 / $618.64	Professional		$254.59	$288.56	$618.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $83.00 / $127.20	Professional	26	$55.00	$83.00	$127.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.49 / $220.00 / $508.96	Professional	TC	$169.49	$220.00	$508.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $260.01 / $260.01 / $260.01	Professional		$260.01	$260.01	$260.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $142.31 / $142.31 / $142.31	Professional	26	$142.31	$142.31	$142.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $241.87 / $394.13 / $609.70	Professional		$241.87	$394.13	$609.70
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.50 / $109.71 / $195.51	Professional	26	$79.50	$109.71	$195.51
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.37 / $302.00 / $438.63	Professional	TC	$162.37	$302.00	$438.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $315.43 / $481.90 / $864.87	Professional		$315.43	$481.90	$864.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.40 / $113.77 / $214.70	Professional	26	$83.40	$113.77	$214.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.81 / $384.00 / $674.86	Professional	TC	$223.81	$384.00	$674.86
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $131.69 / $151.00 / $263.32	Facility	26	$131.69	$151.00	$263.32
Medcost Facility/Professional Professional Modifier Low / Median / High Price $145.72 / $145.72 / $936.89	Professional		$145.72	$145.72	$936.89
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $623.72 / $623.72 / $623.72	Professional	TC	$623.72	$623.72	$623.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $178.71 / $320.65	Professional		$96.53	$178.71	$320.65
United Facility/Professional Professional Modifier Low / Median / High Price $302.17 / $446.31 / $768.53	Professional		$302.17	$446.31	$768.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.50 / $109.58 / $183.18	Professional	26	$82.50	$109.58	$183.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.87 / $321.85 / $623.16	Professional	TC	$213.87	$321.85	$623.16