Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.79 / $84.79 / $103.56	Facility	26	$84.79	$84.79	$103.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.76 / $475.00 / $1,031.45	Professional		$252.76	$475.00	$1,031.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.73 / $110.22 / $189.00	Professional	26	$64.73	$110.22	$189.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $118.21 / $140.41 / $212.50	Professional	52	$118.21	$140.41	$212.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $335.00 / $441.00	Professional	TC	$187.50	$335.00	$441.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $171.76 / $171.76 / $204.45	Professional		$171.76	$171.76	$204.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.78 / $69.58 / $115.87	Professional	26	$51.78	$69.58	$115.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.78 / $395.00 / $606.97	Professional		$208.78	$395.00	$606.97
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.00 / $64.73 / $97.10	Professional	26	$50.00	$64.73	$97.10
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.06 / $345.00 / $532.08	Professional	TC	$144.06	$345.00	$532.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $271.50 / $501.81 / $856.76	Professional		$271.50	$501.81	$856.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.86 / $94.21 / $178.47	Professional	26	$66.86	$94.21	$178.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.45 / $406.11 / $724.42	Professional	TC	$194.45	$406.11	$724.42
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $105.26 / $122.00 / $215.13	Facility	26	$105.26	$122.00	$215.13
Medcost Facility/Professional Professional Modifier Low / Median / High Price $187.72 / $187.72 / $869.99	Professional		$187.72	$187.72	$869.99
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $613.09 / $613.09 / $613.09	Professional	TC	$613.09	$613.09	$613.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.54 / $161.24 / $261.35	Professional		$63.54	$161.24	$261.35
United Facility/Professional Professional Modifier Low / Median / High Price $256.79 / $423.61 / $763.03	Professional		$256.79	$423.61	$763.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.56 / $90.08 / $151.99	Professional	26	$67.56	$90.08	$151.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $179.62 / $285.85 / $653.52	Professional	TC	$179.62	$285.85	$653.52