Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.34 / $83.00 / $103.75	Facility	26	$77.34	$83.00	$103.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $224.25 / $275.00 / $427.24	Professional		$224.25	$275.00	$427.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.07 / $65.31 / $112.92	Professional	26	$50.07	$65.31	$112.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.21 / $220.00 / $357.09	Professional	TC	$169.21	$220.00	$357.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $170.36 / $170.36 / $222.33	Professional		$170.36	$170.36	$222.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.94 / $55.09 / $91.74	Professional	26	$40.94	$55.09	$91.74
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $155.57 / $155.57 / $217.80	Professional	TC	$155.57	$155.57	$217.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $206.82 / $381.00 / $607.50	Professional		$206.82	$381.00	$607.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.25 / $103.00 / $181.10	Professional	26	$51.25	$103.00	$181.10
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $155.57 / $278.00 / $448.75	Professional	TC	$155.57	$278.00	$448.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $236.96 / $336.74 / $581.44	Professional		$236.96	$336.74	$581.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.34 / $76.98 / $141.47	Professional	26	$53.34	$76.98	$141.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $175.40 / $255.15 / $446.24	Professional	TC	$175.40	$255.15	$446.24
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $83.78 / $122.69 / $182.00	Facility	26	$83.78	$122.69	$182.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $145.72 / $145.72 / $825.24	Professional		$145.72	$145.72	$825.24
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $202.58 / $202.58 / $202.58	Professional	26	$202.58	$202.58	$202.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $199.33 / $304.88	Professional		$44.14	$199.33	$304.88
United Facility/Professional Professional Modifier Low / Median / High Price $226.19 / $312.14 / $535.35	Professional		$226.19	$312.14	$535.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.42 / $76.95 / $125.58	Professional	26	$54.42	$76.95	$125.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.12 / $242.55 / $422.15	Professional	TC	$169.12	$242.55	$422.15