Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $125.89 / $162.18	Facility	26	$125.89	$125.89	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $512.86 / $1,737.80	Professional		$331.13	$512.86	$1,737.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $158.49 / $478.63	Professional	26	$97.72	$158.49	$478.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $338.84 / $741.31	Professional	TC	$245.47	$338.84	$741.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $309.03 / $537.03	Professional		$257.04	$309.03	$537.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $102.33 / $173.78	Professional	26	$79.43	$102.33	$173.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $199.53 / $295.12	Professional	TC	$177.83	$199.53	$295.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $602.56 / $1,047.13	Professional		$323.59	$602.56	$1,047.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $147.91 / $331.13	Professional	26	$100.00	$147.91	$331.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $389.05 / $912.01	Professional	TC	$223.87	$389.05	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $776.25 / $1,513.56	Professional		$389.05	$776.25	$1,513.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $134.90 / $223.87	Professional	26	$102.33	$134.90	$223.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $549.54 / $1,230.27	Professional	TC	$281.84	$549.54	$1,230.27
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Professional		$1,096.48	$1,096.48	$1,096.48
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $208.93 / $208.93 / $208.93	Professional	26	$208.93	$208.93	$208.93
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 $371.54 / $645.65 / $1,445.44	Professional		$371.54	$645.65	$1,445.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $125.89 / $218.78	Professional	26	$100.00	$125.89	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $501.19 / $1,174.90	Professional	TC	$263.03	$501.19	$1,174.90