Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $100.00 / $120.23	Facility	26	$93.33	$100.00	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $436.52 / $1,380.38	Professional		$169.82	$436.52	$1,380.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $141.25 / $380.19	Professional	26	$77.62	$141.25	$380.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $338.84 / $616.60	Professional	TC	$245.47	$338.84	$616.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $281.84 / $323.59	Professional		$269.15	$281.84	$323.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $72.44 / $97.72	Professional	26	$57.54	$72.44	$97.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $186.21 / $380.19	Professional	TC	$177.83	$186.21	$380.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $446.68 / $741.31	Professional		$302.00	$446.68	$741.31
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $104.71 / $181.97	Professional	26	$72.44	$104.71	$181.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $323.59 / $512.86	Professional	TC	$229.09	$323.59	$512.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $549.54 / $1,000.00	Professional		$363.08	$549.54	$1,000.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $102.33 / $177.83	Professional	26	$74.13	$102.33	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $446.68 / $776.25	Professional	TC	$281.84	$446.68	$776.25
Medcost Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Professional		$812.83	$812.83	$812.83
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $151.36 / $151.36	Professional	26	$151.36	$151.36	$151.36
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 $338.84 / $512.86 / $933.25	Professional		$338.84	$512.86	$933.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $93.33 / $158.49	Professional	26	$74.13	$93.33	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $426.58 / $758.58	Professional	TC	$263.03	$426.58	$758.58