Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.65 / $78.66 / $96.03	Facility	26	$78.65	$78.66	$96.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $432.56 / $651.82	Professional		$250.00	$432.56	$651.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.76 / $102.25 / $176.40	Professional	26	$64.76	$102.25	$176.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.98 / $335.00 / $455.72	Professional	TC	$217.98	$335.00	$455.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $274.04 / $294.58 / $294.58	Professional		$274.04	$294.58	$294.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.02 / $60.02 / $107.44	Professional	26	$48.02	$60.02	$107.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $325.63 / $325.63 / $325.63	Professional	TC	$325.63	$325.63	$325.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.41 / $460.00 / $662.58	Professional		$275.41	$460.00	$662.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.02 / $94.23 / $133.75	Professional	26	$60.02	$94.23	$133.75
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $214.02 / $358.00 / $532.15	Professional	TC	$214.02	$358.00	$532.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $360.45 / $502.73 / $844.13	Professional		$360.45	$502.73	$844.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.68 / $85.93 / $165.56	Professional	26	$61.68	$85.93	$165.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $289.70 / $430.07 / $721.80	Professional	TC	$289.70	$430.07	$721.80
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $96.62 / $113.00 / $198.24	Facility	26	$96.62	$113.00	$198.24
Medcost Facility/Professional Professional Modifier Low / Median / High Price $187.72 / $187.72 / $1,040.48	Professional		$187.72	$187.72	$1,040.48
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $238.32 / $238.32 / $238.32	Professional	26	$238.32	$238.32	$238.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.54 / $231.17 / $377.11	Professional		$63.54	$231.17	$377.11
United Facility/Professional Professional Modifier Low / Median / High Price $335.34 / $465.88 / $817.55	Professional		$335.34	$465.88	$817.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.59 / $83.15 / $138.51	Professional	26	$61.59	$83.15	$138.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $267.23 / $375.80 / $667.06	Professional	TC	$267.23	$375.80	$667.06