Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.09 / $127.10 / $157.60	Facility	26	$127.09	$127.10	$157.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.94 / $475.00 / $1,300.65	Professional		$347.94	$475.00	$1,300.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.18 / $140.00 / $332.53	Professional	26	$85.18	$140.00	$332.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $243.60 / $335.00 / $462.42	Professional	TC	$243.60	$335.00	$462.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $253.50 / $308.14 / $331.25	Professional		$253.50	$308.14	$331.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.15 / $103.59 / $174.81	Professional	26	$79.15	$103.59	$174.81
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $294.66 / $294.66 / $294.66	Professional	TC	$294.66	$294.66	$294.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $308.14 / $660.00 / $1,173.96	Professional		$308.14	$660.00	$1,173.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.66 / $174.78 / $344.10	Professional	26	$97.66	$174.78	$344.10
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $210.47 / $395.00 / $944.29	Professional	TC	$210.47	$395.00	$944.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $400.55 / $815.15 / $1,459.17	Professional		$400.55	$815.15	$1,459.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.40 / $142.12 / $267.51	Professional	26	$103.40	$142.12	$267.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $284.27 / $604.19 / $1,201.34	Professional	TC	$284.27	$604.19	$1,201.34
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $161.40 / $189.00 / $321.67	Facility	26	$161.40	$189.00	$321.67
Medcost Facility/Professional Professional Modifier Low / Median / High Price $300.42 / $300.42 / $1,280.42	Professional		$300.42	$300.42	$1,280.42
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $383.97 / $383.97 / $383.97	Professional	26	$383.97	$383.97	$383.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $243.45 / $407.48	Professional		$96.53	$243.45	$407.48
United Facility/Professional Professional Modifier Low / Median / High Price $376.79 / $618.54 / $1,323.59	Professional		$376.79	$618.54	$1,323.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.69 / $131.27 / $223.92	Professional	26	$100.69	$131.27	$223.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $268.49 / $437.99 / $1,111.55	Professional	TC	$268.49	$437.99	$1,111.55