Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.45 / $83.00 / $102.92	Facility	26	$70.45	$83.00	$102.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.48 / $260.51 / $379.63	Professional		$95.48	$260.51	$379.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $61.45 / $143.37	Professional	26	$43.82	$61.45	$143.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.00 / $192.00 / $249.60	Professional	TC	$104.00	$192.00	$249.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.99 / $141.13 / $151.71	Professional		$120.99	$141.13	$151.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.19 / $44.04 / $78.83	Professional	26	$35.19	$44.04	$78.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $104.38 / $104.38 / $135.94	Professional	TC	$104.38	$104.38	$135.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.13 / $294.00 / $486.25	Professional		$141.13	$294.00	$486.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.04 / $99.00 / $148.96	Professional	26	$44.04	$99.00	$148.96
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.10 / $195.00 / $337.50	Professional	TC	$97.10	$195.00	$337.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.97 / $254.89 / $436.32	Professional		$179.97	$254.89	$436.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.03 / $67.50 / $116.38	Professional	26	$50.03	$67.50	$116.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.80 / $191.95 / $322.82	Professional	TC	$128.80	$191.95	$322.82
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $78.59 / $92.00 / $147.12	Facility	26	$78.59	$92.00	$147.12
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $88.83 / $554.32	Professional		$88.83	$88.83	$554.32
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $175.09 / $175.09 / $175.09	Professional	26	$175.09	$175.09	$175.09
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $133.25 / $133.25 / $831.48	Professional	50	$133.25	$133.25	$831.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $127.90 / $207.66	Professional		$44.14	$127.90	$207.66
United Facility/Professional Professional Modifier Low / Median / High Price $167.39 / $235.99 / $399.37	Professional		$167.39	$235.99	$399.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.15 / $64.95 / $102.33	Professional	26	$47.15	$64.95	$102.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $118.06 / $167.46 / $320.69	Professional	TC	$118.06	$167.46	$320.69