Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.98 / $124.98 / $146.97	Facility	26	$124.98	$124.98	$146.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $475.50 / $803.27	Professional		$250.00	$475.50	$803.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $140.00 / $199.08	Professional	26	$85.00	$140.00	$199.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $298.83 / $350.51 / $543.97	Professional	TC	$298.83	$350.51	$543.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $351.11 / $377.44 / $377.44	Professional		$351.11	$377.44	$377.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.61 / $95.75 / $171.39	Professional	26	$77.61	$95.75	$171.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $351.11 / $481.00 / $1,029.50	Professional		$351.11	$481.00	$1,029.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.75 / $140.00 / $187.25	Professional	26	$95.75	$140.00	$187.25
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $255.36 / $340.13 / $943.32	Professional	TC	$255.36	$340.13	$943.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $462.76 / $763.28 / $1,449.59	Professional		$462.76	$763.28	$1,449.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.23 / $137.25 / $263.06	Professional	26	$98.23	$137.25	$263.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $348.77 / $633.16 / $1,143.83	Professional	TC	$348.77	$633.16	$1,143.83
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $154.59 / $179.00 / $315.36	Facility	26	$154.59	$179.00	$315.36
Medcost Facility/Professional Professional Modifier Low / Median / High Price $300.42 / $300.42 / $1,476.12	Professional		$300.42	$300.42	$1,476.12
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $376.43 / $376.43 / $376.43	Professional	26	$376.43	$376.43	$376.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $290.24 / $475.77	Professional		$96.53	$290.24	$475.77
United Facility/Professional Professional Modifier Low / Median / High Price $430.91 / $611.45 / $1,277.82	Professional		$430.91	$611.45	$1,277.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.98 / $124.96 / $209.28	Professional	26	$97.98	$124.96	$209.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $316.64 / $483.75 / $1,063.42	Professional	TC	$316.64	$483.75	$1,063.42