Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.04 / $79.04 / $96.03	Facility	26	$79.04	$79.04	$96.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.62 / $425.00 / $1,121.15	Professional		$186.62	$425.00	$1,121.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.04 / $112.04 / $377.00	Professional	26	$65.04	$112.04	$377.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,218.00 / $1,218.00 / $1,218.00	Professional	50	$1,218.00	$1,218.00	$1,218.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $103.30 / $123.88 / $212.50	Professional	52	$103.30	$123.88	$212.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $168.71 / $335.00 / $458.92	Professional	TC	$168.71	$335.00	$458.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $153.51 / $186.62 / $200.62	Professional		$153.51	$186.62	$200.62
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 $136.10 / $192.62 / $226.61	Professional	TC	$136.10	$192.62	$226.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.62 / $460.00 / $746.11	Professional		$186.62	$460.00	$746.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.02 / $140.00 / $233.34	Professional	26	$60.02	$140.00	$233.34
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $126.60 / $320.00 / $508.54	Professional	TC	$126.60	$320.00	$508.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.18 / $475.46 / $791.74	Professional		$234.18	$475.46	$791.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.68 / $87.03 / $166.37	Professional	26	$61.68	$87.03	$166.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $164.76 / $355.12 / $629.00	Professional	TC	$164.76	$355.12	$629.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $97.46 / $135.72 / $264.00	Facility	26	$97.46	$135.72	$264.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $187.72 / $187.72 / $760.25	Professional		$187.72	$187.72	$760.25
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $239.35 / $239.35 / $239.35	Professional	26	$239.35	$239.35	$239.35
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $281.58 / $281.58 / $1,140.38	Professional	50	$281.58	$281.58	$1,140.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.54 / $140.61 / $242.81	Professional		$63.54	$140.61	$242.81
United Facility/Professional Professional Modifier Low / Median / High Price $218.93 / $363.84 / $733.38	Professional		$218.93	$363.84	$733.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.59 / $82.42 / $140.11	Professional	26	$61.59	$82.42	$140.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.91 / $249.70 / $620.92	Professional	TC	$151.91	$249.70	$620.92