Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.54 / $83.00 / $102.92	Facility	26	$72.54	$83.00	$102.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.91 / $275.00 / $357.50	Professional		$137.91	$275.00	$357.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.78 / $65.59 / $143.37	Professional	26	$46.78	$65.59	$143.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.02 / $192.00 / $285.50	Professional	TC	$84.02	$192.00	$285.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $122.49 / $122.49 / $122.49	Professional		$122.49	$122.49	$122.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.95 / $48.10 / $86.10	Professional	26	$38.95	$48.10	$86.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $61.62 / $61.62 / $61.62	Professional	TC	$61.62	$61.62	$61.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.49 / $336.00 / $532.54	Professional		$122.49	$336.00	$532.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.10 / $111.00 / $157.69	Professional	26	$48.10	$111.00	$157.69
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $74.39 / $225.00 / $398.61	Professional	TC	$74.39	$225.00	$398.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.19 / $252.86 / $429.62	Professional		$146.19	$252.86	$429.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.03 / $71.55 / $132.80	Professional	26	$50.03	$71.55	$132.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $90.74 / $187.82 / $325.75	Professional	TC	$90.74	$187.82	$325.75
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $79.09 / $106.00 / $165.00	Facility	26	$79.09	$106.00	$165.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $88.83 / $496.06	Professional		$88.83	$88.83	$496.06
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $190.11 / $190.11 / $190.11	Professional	26	$190.11	$190.11	$190.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $118.03 / $176.54	Professional		$44.14	$118.03	$176.54
United Facility/Professional Professional Modifier Low / Median / High Price $137.15 / $198.10 / $399.65	Professional		$137.15	$198.10	$399.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.02 / $66.95 / $111.11	Professional	26	$50.02	$66.95	$111.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.68 / $142.54 / $320.08	Professional	TC	$83.68	$142.54	$320.08